Home Parenteral Nutrition in Adults: Catheter Complications, Quality of Life and the Cost of Getting Follow-Up Wrong
DOI:
https://doi.org/10.5281/zenodo.22278446Keywords:
Home parenteral nutrition, Catheter-related bloodstream infection, Intestinal failure, Venous access, Follow-upAbstract
Catheter-related infection is the commonest serious complication of home parenteral nutrition, and the reported rate spans a
twelve-fold range. A systematic review of 39 studies found bloodstream infection rates between 0.38 and 4.58 episodes per 1,000
catheter days, median 1.31, and reported extensive variability in the terminology and definitions used, to the point that ten of the
thirty papers giving a rate could not be categorised at all. The denominator moves the figure too: one cohort reported 0.91
episodes per 1,000 total catheter days and 1.49 per 1,000 nutrition days. Device type matters more than either, with 1.91 for
peripherally inserted catheters against 0.63 for tunnelled and none recorded for implanted ports. Where a standardised protocol
was applied in a high-risk oncology population, the rate was 0.54 per 1,000 nutrition days.
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