Abstract：
Central venous catheter (CVC) complications are frequently reported in patients receiving home parenteral support (HPS). Compromised CVC integrity or breakage is one such issue. Repairing such breakages can potentially avoid costly and risky catheter replacements.
We completed a retrospective descriptive cohort study using a prospectively maintained data set, in a national UK intestinal failure reference center. Repair success, CVC longevity, and catheter-related bloodstream infection (CRBSI) rates after repair were the primary outcome measures.
A total of 763 patients received HPS. There were 137 CVC repairs: 115 (84%) tunneled CVCs and 22 peripherally inserted central catheters (PICCs) attempted in 72 patients. Of the 137 attempts at CVC repair, 120 (88%) were deemed to be successful, allowing a median duration of subsequent CVC use of 336 days following repair (range 3-1696 days), which equates to 99,602 catheter days of HPS infusion. Three patients had a CRBSI within 90 days of repair, and patients required admission to the hospital for refeeding on 14 occasions following repair, such that hospitalization was avoided in 103/120 (86%) occasions following successful CVC repair. There was no increase in the recorded rate of CRBSIs in patients undergoing CVC repair compared with the CRBSI rates of all HPS-dependent patients under our care during the study period (0.03 vs 0.344/1000 catheter days, respectively).
This is the largest single-center experience to demonstrate that CVCs, including PICCs, used for the administration of HPS can be safely repaired, prolonging CVC longevity without leading to an increased risk of CRBSI.
We completed a retrospective descriptive cohort study using a prospectively maintained data set, in a national UK intestinal failure reference center. Repair success, CVC longevity, and catheter-related bloodstream infection (CRBSI) rates after repair were the primary outcome measures.
A total of 763 patients received HPS. There were 137 CVC repairs: 115 (84%) tunneled CVCs and 22 peripherally inserted central catheters (PICCs) attempted in 72 patients. Of the 137 attempts at CVC repair, 120 (88%) were deemed to be successful, allowing a median duration of subsequent CVC use of 336 days following repair (range 3-1696 days), which equates to 99,602 catheter days of HPS infusion. Three patients had a CRBSI within 90 days of repair, and patients required admission to the hospital for refeeding on 14 occasions following repair, such that hospitalization was avoided in 103/120 (86%) occasions following successful CVC repair. There was no increase in the recorded rate of CRBSIs in patients undergoing CVC repair compared with the CRBSI rates of all HPS-dependent patients under our care during the study period (0.03 vs 0.344/1000 catheter days, respectively).
This is the largest single-center experience to demonstrate that CVCs, including PICCs, used for the administration of HPS can be safely repaired, prolonging CVC longevity without leading to an increased risk of CRBSI.
摘要：
背景：在接受家庭肠胃外支持（HPS）的患者中，经常报告中心静脉导管（CVC）并发症。受损的CVC完整性或破损是一个这样的问题。修复这种破损可以潜在地避免昂贵且有风险的导管更换。
方法：我们利用前瞻性维护的数据集完成了一项回顾性描述性队列研究，在英国国家肠道衰竭参考中心。修复成功,修复后的CVC寿命和导管相关血流感染率（CRBSI）是主要结果指标。
结果：在研究期间，共有763例患者接受了HPS.有137个CVC维修(115(84%)隧道化CVC,在72例患者中尝试了22例外周插入的中央导管。在CVC修复的137次尝试中，120（88%）被认为是成功的；允许后续CVC使用的中位持续时间为336天，在修复后（范围3-1696天），相当于99602天的导管输注HPS。三名患者在修复后90天内患有CRBSI，患者在修复后14次需要入院重新喂养，这样，在成功的CVC修复后，103/120（86％）的情况下避免了住院。在研究期间，与接受我们护理的所有HPS依赖性患者的CRBSI相比，接受CVC修复的患者的CRBSI记录率没有增加（0.03vs0.344/1000导管天，分别)。
结论：这是最大的单中心经验，以证明CVC，包括PICCs，用于HPS的管理，可以安全地修复，延长CVC的寿命，而不会导致CRBSI的风险增加。本文受版权保护。保留所有权利。
方法：我们利用前瞻性维护的数据集完成了一项回顾性描述性队列研究，在英国国家肠道衰竭参考中心。修复成功,修复后的CVC寿命和导管相关血流感染率（CRBSI）是主要结果指标。
结果：在研究期间，共有763例患者接受了HPS.有137个CVC维修(115(84%)隧道化CVC,在72例患者中尝试了22例外周插入的中央导管。在CVC修复的137次尝试中，120（88%）被认为是成功的；允许后续CVC使用的中位持续时间为336天，在修复后（范围3-1696天），相当于99602天的导管输注HPS。三名患者在修复后90天内患有CRBSI，患者在修复后14次需要入院重新喂养，这样，在成功的CVC修复后，103/120（86％）的情况下避免了住院。在研究期间，与接受我们护理的所有HPS依赖性患者的CRBSI相比，接受CVC修复的患者的CRBSI记录率没有增加（0.03vs0.344/1000导管天，分别)。
结论：这是最大的单中心经验，以证明CVC，包括PICCs，用于HPS的管理，可以安全地修复，延长CVC的寿命，而不会导致CRBSI的风险增加。本文受版权保护。保留所有权利。
