Central Venous Access in the Home Parenteral Nutrition Population–You PICC

Abstract

Background: Central venous access is imperative for the delivery of home parenteral nutrition (HPN). Peripherally inserted central catheters (PICC) are being used more frequently for the delivery of HPN. There is an abundance of short-term information on the use of PICC in the hospitalized patient. However, there are no data comparing the use of PICC to other central venous access devices (OCVAD; Hickman, port) for the delivery of HPN. Catheter-related infections (CRI) are the most common cause of hospital readmission for the HPN patients. Methods: A retrospective analysis was performed from the Digestive Disease Center HPN database at the Medical University of South Carolina and the open architecture clinical information system (OACIS) hospital and clinic reporting system. All CRI were analyzed and compared between patients with PICC and OCVAD. The PICC group and the OCVAD group were further broken down into diabetic patients and nondiabetic patients, and the incidence of CRI was compared within those groups. Results: HPN patients with PICC had a statistically significant increase (p < .01) of CRI as compared with OCVAD within our HPN patients. There was no statistically significant increase in CRI between diabetic and nondiabetic patients. Conclusions: The use of PICC for HPN may be associated with an increase in CRI. A prospective, randomized trial in the HPN population between PICC and OCVAD must be performed.

Home parenteral nutrition (HPN) is a commonly prescribed therapy. Peripherally inserted central catheters (PICC) are being used more frequently for HPN delivery. A retrospective analysis of PICC versus other central venous access devices for the delivery of HPN revealed an increase in catheter-related infections in the PICC group.