Repair of central venous access devices in intestinal failure patients is safe and cost-effective: A retrospective single centre cohort study.

Fletcher, Jane, Woodham, Diane and Cooper, Sheldon C (2021) Repair of central venous access devices in intestinal failure patients is safe and cost-effective: A retrospective single centre cohort study. Clinical nutrition (Edinburgh, Scotland). ISSN 1532-1983. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

INTRODUCTION

Patients with chronic intestinal failure (IF) require home parenteral nutrition (HPN). Central venous access is needed for prolonged use of PN, usually via a long term central venous access device (CVAD). Post insertion there may be mechanical complications with a CVAD such as catheter rupture or tear. Repair of damaged CVADs is possible to avoid risks associated with catheter replacement in patients with IF. However, catheter related blood stream infections (CRBSI) are a concern when CVAD's are accessed or manipulated.

AIMS

To investigate the success of repair of CVADs in patients with IF on HPN, related to repair longevity and incidence of CRBSI following repair.

METHOD

Nutrition team records of CVAD repairs carried out in patients with IF were reviewed retrospectively for the period April 2015 to March 2019.

RESULTS

Nutrition Clinical Nurse Specialists carried out 38 repairs in 27 patients. Male n = 5, female n = 22; mean age 55 years. Catheter longevity before first repair (n = 27): median 851 days, IQR 137-1484 days. 30/38 (78.9%) of repairs were successful lasting ≥30days. Hospital admission was avoided in 76% of cases. 4 patients in the failed repair group underwent catheter re-insertion where 4 had a further, subsequently successful, repair, an overall success rate of 89.4% (34/38). 30-day CRBSI rate was 0.09/1000 catheter days in repaired catheters. In comparing costs, there is a potential cost saving of 2766GBP for repair compared to replacement of damaged CVADs.

CONCLUSION

Repair of tunnelled CVADs in patients with IF is successful and safe with no increased risk of CRBSI. Significant cost savings may be made.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QW Microbiology. Immunology
W Public health. Health statistics. Occupational health. Health education
WI Digestive system. Gastroenterology
WO Surgery
WY Nursing
Divisions: Planned IP Care > Gastroentrology
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Depositing User: Jamie Edgar
Date Deposited: 17 Feb 2021 10:20
Last Modified: 17 Feb 2021 10:20
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3975

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