优化长期肠外营养的静脉通路。

IF 4.6 3区 医学 Q1 NUTRITION & DIETETICS
Current Nutrition Reports Pub Date : 2024-06-01 Epub Date: 2024-05-02 DOI:10.1007/s13668-024-00534-y
Ryan T Hurt, Osman Mohamed Elfadil, Jithinraj Edakkanambeth Varayil, Sara L Bonnes, Bradley R Salonen, Manpreet S Mundi
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引用次数: 0

摘要

审查目的:确保安全有效的静脉(IV)通路对于实施肠外营养(PN)至关重要。维持这种通路确实会带来挑战,尤其是在处理与长期肠外营养相关的并发症风险时。本综述强调了优化静脉通路的最佳实践,并回顾了当前的循证建议和共识指南:建议在选择中心静脉导管(CVC)时采用个体化方法,同时考虑到静脉通路的预计需求持续时间和所需管腔的数量。为最大限度地减少感染和血栓形成等并发症,已有的和新的方法得到了认可。这些方法包括在超声引导下放置和定位导管尖端,以及使用抗菌素锁定疗法。此外,在可能的情况下,抢救 CVC 可以降低血管通路丢失的风险。为需要 PN 的患者选择 CVC 取决于多个因素。仔细审查每位患者的临床特征并讨论各种选择非常重要。鉴于感染风险增加,应尽量减少 CVC 管腔。对于超过 6 个月的长期 PN,应考虑使用带有皮肤屏障和更大直径的 CVC。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimizing Intravenous Access for Long-Term Parenteral Nutrition.

Purpose of review: Securing safe and effective intravenous (IV) access is of utmost importance for administering parenteral nutrition (PN). Sustaining this access can indeed pose challenges, especially when dealing with the risk of complications associated with long-term PN. This review emphasizes best practices to optimize intravenous access and reviews the current evidence-based recommendations and consensus guidelines.

Recent findings: An individualized approach when selecting central venous catheters (CVC) is recommended, considering the estimated duration of need for IV access and the number of lumens needed. Established and novel approaches to minimize complications, including infection and thrombosis, are recognized. These include placement and positioning of the catheter tip under sonographic guidance and the use of antimicrobial lock therapies. Moreover, when possible, salvaging CVCs can reduce the risk of vascular access loss. CVC selection for patients requiring PN depends on several factors. Carefully reviewing an individual patient's clinical characteristics and discussing options is important. Given the increased infection risk, CVC lumens should be minimized. For long-term PN beyond 6 months, using CVCs with skin barriers and larger diameters should be considered.

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来源期刊
Current Nutrition Reports
Current Nutrition Reports Agricultural and Biological Sciences-Food Science
CiteScore
7.70
自引率
2.00%
发文量
59
期刊介绍: This journal aims to provide comprehensive review articles that emphasize significant developments in nutrition research emerging in recent publications. By presenting clear, insightful, balanced contributions by international experts, the journal intends to discuss the influence of nutrition on major health conditions such as diabetes, cardiovascular disease, cancer, and obesity, as well as the impact of nutrition on genetics, metabolic function, and public health. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 25 internationally diverse members reviews the annual table of contents, suggests topics of special importance to their country/region, and ensures that topics and current and include emerging research.
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