REDUCTION IN THE INCIDENCE OF COMPLICATIONS DUE TO USING OF SKIN-TUNNELED CATHETERS IN CHILDREN WITH SHORT BOWEL SYNDROME RECEIVING HOME PARENTERAL NUTRITION

Cover Page


Cite item

Full Text

Abstract

The number of patients with chronic intestinal failure including «short bowel syndrome» (SBS) who require long-term parenteral nutrition (PN) is growing now. 10-year experience of authors in providing home parenteral nutrition (HPN) in Russia shows that HPN is cost-saving method that improves prognosis of patients. The effect of skin-tunneled catheters and venous port-systems in hospital and home PN was analyzed in the open prospective study. 23 PN periods in 20 children were studied. The incidence of catheter-associated infections was 2.58 for 1000 catheter-days for tunneled catheter or port. It was shown that skin-tunneled central venous catheters (CVC) and port-systems reduce the incidence of all infectious complications by 10 cases (p=0.033) per 1000 catheter-days in average, the incidence of catheter-related system infections by 9 cases (p=0.004), the incidence of technical complications by 5 cases (p=0.005) per 1000 catheter-days if compared with standard CVC. Our results make it possible to recommend the use of skin-tunneled CVC and port-systems as a method of choice for patients requiring long-term PN.

About the authors

A. I. Chubarova

Russian National Research Medical university named after N.I. Pirogov; Children's City Hospital named after N.F. Filatov

Author for correspondence.
Email: ach-08@yandex.ru
Россия

E. A. Kostomarova

Bashlyaevskaja Pediatric City Hospital; Russian National Research Medical university named after N.I. Pirogov

Email: eleni@abloy.ru
Россия

N. S. Zhikhareva

Bashlyaevskaja Pediatric City Hospital

Email: natali_sf@hotmail.com
Россия

E. R. Radchenko

Bashlyaevskaja Pediatric City Hospital

Email: elen.radchenko@list.ru
Россия

References

  1. Бережанский Б.В., Жевнерев А.А. Катетер-ассоциированные инфекции кровотока // Клиническая микробиология, антимикробная химиотерапия. 2006. Т. 8, № 2. С. 130-142.
  2. Биккулова Д.Ш., Заболотский Д.В., Ершова О.Н., Кулабухов В.В. Клинические рекомендации по профилактике катетер-ассоциированных инфекций и уходу за центральным венозным катетером // Клинические рекомендации. Драфт 14-го съезда ФАР. 19-22 сентября 2014 г.
  3. Исаков Ю.Ф., Володин Н.Н., Гераськин А.В. Неонатальная хирургия. - М.: Династия, 2011. - 680 с.
  4. Лечение детей с синдромом короткой кишки: Федеральные клинические рекомендации российской ассоциации детских хирургов. - М., 2014; http://www.radh.ru/Short_intestinal.pdf.
  5. Чубарова А.И. Лечебное энтеральное и парентеральное питание // Парентеральное и энтеральное питание: Национальное руководство / Под ред. М.Ш. Хубутия, Т.С. Поповой, А.И. Салтанова. - М.: Гэотар-Медиа, 2014. С. 653-692.
  6. Barclay A.R., Paxton C.E., Gillett P. Regionally acquired intestinal failure data suggest an underestimate in national service requirements // Arch.Dis. Child. 2009, Dec. Vol. 94, N 12. P. 938-944.
  7. Bianchi A. Autologous gastrointestinal reconstruction for short bowel syndrome // Br.J. Hosp. Med. (Lond). 2007, Jan. Vol. 68, N 1. Р. 24-27.
  8. Celebi S., Sezgin M.E., Cakir D., Baytan B., Demirkaya M., Sevinir B., Bozdemir S.E., Gunes A.M., Hacimustafaoglu M. Catheter-associated bloodstream infections in pediatric hematology-oncology patients // Pediatr. Hematol. Oncol. 2013, Apr. Vol. 30, N 3. Р. 187-194.
  9. Gandullia P., Lugani F., Costabello L., Arrigo S., Calvi A., Castellano E., Vignola S., Pistorio A., Barabino A.V. Longterm home parenteral nutrition in children with chronic intestinal failure: A 15-year experience at a single Italian centre // Dig. Liver Dis. 2011, Jan. Vol. 43, N 1. Р. 28-33.
  10. Goes-Silva E., Abreu T.F., Frota A.C. C. Use of Peripherally Inserted Central Catheters to Prevent Catheter-Associated Bloodstream Infection in Children // Infect. Control Hosp. Epidemiol. 2009, Oct. Vol. 30, N 10. P. 1024-1026.
  11. Jeffries H.E., Mason W., Brewer M., Oakes K.L., Munoz E.I., Gornick W., Flowers L.D., Mullen J.E., Gilliam C.H., Fustar S., Thurm C.W., Logsdon T., Jarvis W.R. Рrevention of central venous catheter-associated bloodstream infections in pediatric intensive care units: a performance improvement collaborative // Infect. Control Hosp. Epidemiol. 2009, Jul. Vol. 30, N 7. Р. 645-651.
  12. Baskin K.M., Hunnicutt Ch., Beck M.E., Cohen E.D., Crowley J.J., Fitz Ch.R. Long-Term Central Venous Access in Pediatric Patients at High Risk: Conventional versus Antibiotic - Impregnated Catheters // J. Vasc.Int. Radiology. 2014. Vol. 25, Is. 3. Р. 411-418.
  13. Piedra P.A., Dryja D.M., LaScolea L.J. Jr. Incidence of catheter-associated gram-negative вacteremia in children with short bowel syndrome // J. Clin. Microbiol. 1989. Vol. 27, N 6. P. 1317.
  14. Pieroni K.P., Nespor C., Ng M., Garcia M., Hurwitz M., Berquist W.E., Kerner J.A. Jr. Evaluation of ethanol lock therapy in pediatric patients on long-term parenteral nutrition // Nutr. Clin. Pract. 2013, Apr. Vol. 28, N 2. P. 226-231.
  15. Rowe M.I., O’Neill J.A., Grosfeld J.L., Fonkalsrud Coran A.G. Short-bowel syndrome // Essentials of Pediatric Surgery. - Mosby Year book, 1995. Р. 536-541.
  16. Sukhotnik I. Short Bowel Syndrome // Gastrointestinal Disorders / M. Battik, N. Grimaldi (Eds.). - Nova Science Publ., 2012; http://vetemadezhd.ru/system/resources/BAhbBlsHOgZmSSIzMjAxNC8wNi8xMS8xNV8xMl8yNF82MTRfQ2hhcHRlcl9maW5hbF9ydXNfLnBkZgY6BkVU/Chapter-final_rus_.pdf.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2015 Chubarova A.I., Kostomarova E.A., Zhikhareva N.S., Radchenko E.R.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: ПИ № ФС 77 - 81892 от 24.09.2021 г.