Selection and Care of Central Venous Access Devices for Adult Home Parenteral Nutrition Administration
Publication Date: October 19, 2018
Last Updated: March 14, 2022
Recommendations
Based on observational studies and expert consensus, we suggest tunneled CVADs should be selected for adult patients anticipated to require long-term daily PN infusions. (W - Weak, L - Low)
If the duration of HPN is uncertain or of short duration (<30 days), PICCs may be used.
658
Based on 1 observational study and expert opinion, we suggest using the fewest number of lumens required for individual patient therapy. (W - Weak, VL - Very Low)
658
We cannot make a recommendation at this time regarding CVAD composition to minimize infection. (, VL - Very Low)
(Further research is needed)
658
Based upon observational cohort studies, the risk for mechanical complications does not differ by the type of CVAD. (W - Weak, L - Low)
658
The choice of CVAD should be selected based upon length of therapy, patient choice, and the ability of the patient/caregiver to care for the CVAD. (W - Weak, L - Low)
658
Should antimicrobial/ethanol locks be used versus standard care for treating or preventing CVAD infections?
No recommendation can be made at this time. (W - Weak, L - Low)
658
No recommendations can be made as to which flush solution should be used to maintain patency for HPN CVADs due to the lack of studies. (GPR, VL - Very Low)
658
Recommendation Grading
Overview
Title
Selection and Care of Central Venous Access Devices for Adult Home Parenteral Nutrition Administration
Authoring Organization
American Society for Parenteral and Enteral Nutrition
Publication Month/Year
October 19, 2018
Last Updated Month/Year
January 23, 2024
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Home health, Long term care
Intended Users
Dietician nutritionist, nurse, nurse practitioner, physician, physician assistant
Scope
Management
Diseases/Conditions (MeSH)
D018529 - Nutritional Support, D062905 - Central Venous Catheters
Keywords
Central Venous Access Devices, Home Parenteral Nutrition , home health, catheter flushing