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Current Nutrition Reports

Optimizing Intravenous Access for Long-Term Parenteral Nutrition

Published in:
Authors
Ryan T. Hurt
Osman Mohamed Elfadil
Jithinraj Edakkanambeth Varayil
Sara L. Bonnes
Bradley R. Salonen
Manpreet S. Mundi
Published in
Current Nutrition Reports | Issue 2/2024

Abstract

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.

Summary

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.
Title
Optimizing Intravenous Access for Long-Term Parenteral Nutrition
Authors
Ryan T. Hurt
Osman Mohamed Elfadil
Jithinraj Edakkanambeth Varayil
Sara L. Bonnes
Bradley R. Salonen
Manpreet S. Mundi
Publication date
02-05-2024
Publisher
Springer US
Published in
Current Nutrition Reports / Issue 2/2024
Electronic ISSN: 2161-3311
DOI
https://doi.org/10.1007/s13668-024-00534-y
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