Optimal Frequency of Changing Intravenous Administration Sets: Is It Safe to Prolong Use Beyond 72 Hours?

2001 ◽  
Vol 22 (03) ◽  
pp. 136-139 ◽  
Author(s):  
Issam Raad ◽  
Hend A. Hanna ◽  
Abeer Awad ◽  
Amin Alrahwan ◽  
Carol Bivins ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Randomized Study ◽  
Interleukin 2 ◽  
Group Versus ◽  
Cost Effective ◽  
Cancer Center ◽  
Infusion Therapy ◽  
Blood Transfusions ◽  
Comparable Rate

AbstractObjective:To determine the safety and cost-effectiveness of replacing the intravenous (TV) tubing sets in hospitalized patients at 4- to 7-day intervals instead of every 72 hours.Design:Prospective, randomized study of infusion-related contamination associated with changing IV tubing sets within 3 days versus within 4 to 7 days of placement.Setting:A tertiary university cancer center.Patients and Methods:Cancer patients requiring IV infusion therapy were randomized to have the IV tubing sets replaced within 3 days (280 patients) or within 4 to 7 days of placement (232 patients). Demographic, microbiological, and infusion-related data were collected for all participants. The main outcome measures were infusion- or catheter-related contamination or colonization of IV tubing, determined by quantitative cultures of the infusate, and infusion- or catheter-related bloodstream infection (BSI), determined by quantitative culture of the infusate in association with blood cultures in febrile patients.Results:The two groups were comparable in terms of patient and catheter characteristics and the agents given through the IV tubing. Intent-to-treat analysis demonstrated a higher level of tubing colonization in the 4- to 7-day group versus the 3-day group (median, 145 vs 50 colony-forming units;P=.02). In addition, there were three episodes of possible infusion-related BSIs, all of which occurred in the 4- to 7-day group (P=.09). However, when the 84 patients who received total parenteral nutrition, blood transfusions, or interleukin-2 through the IV tubing were excluded, the two groups had a comparable rate of colonization (0.4% vs 0.5%), with no catheter- or infusion-related BSIs in either group.Conclusion:In patients at low risk for infection from infusion- or catheter-related infection who are not receiving total parenteral nutrition, blood transfusions, or interleukin-2, delaying the replacement of IV tubing up to 7 days may be safe, as well as cost-effective.

Effects of Total Parenteral Nutrition (TPN) During High-Dose Interleukin-2 Treatment for Metastatic Cancer

1998 ◽  
Vol 21 (1) ◽  
pp. 65-74 ◽  
Author(s):  
Wolfram E. Samlowski ◽  
Gail Wiebke ◽  
Martha McMurry ◽  
Motomi Mori ◽  
John H. Ward
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Metastatic Cancer ◽  
Interleukin 2 ◽  
High Dose

Periodic Reassessment for Improved, Cost-Effective Care in Home Total Parenteral Nutrition: A Case Report

1984 ◽  
Vol 8 (6) ◽  
pp. 708-710 ◽  
Author(s):  
Richard J. Baptista ◽  
Margaret A. Lahey ◽  
Bruce R. Bistrian ◽  
Charlotte D. Champagne ◽  
Donald G. Miller ◽  
...  
Keyword(s):  
Case Report ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Cost Effective ◽  
Effective Care

scholarly journals Environmental Exposures and the Risk of Central Venous Catheter Complications and Readmissions in Home Infusion Therapy Patients

2016 ◽  
Vol 38 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Sara C. Keller ◽  
Deborah Williams ◽  
Mitra Gavgani ◽  
David Hirsch ◽  
John Adamovich ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Environmental Exposures ◽  
Infusion Therapy ◽  
Central Venous ◽  
Home Infusion Therapy ◽  
Home Infusion

BACKGROUNDPatients are frequently discharged with central venous catheters (CVCs) for home infusion therapy.OBJECTIVETo study a prospective cohort of patients receiving home infusion therapy to identify environmental and other risk factors for complications.DESIGNProspective cohort study between March and December 2015.SETTINGHome infusion therapy after discharge from academic medical centers.PARTICIPANTSOf 368 eligible patients discharged from 2 academic hospitals to home with peripherally inserted central catheters and tunneled CVCs, 222 consented. Patients remained in the study until 30 days after CVC removal.METHODSPatients underwent chart abstraction and monthly telephone surveys while the CVC was in place, focusing on complications and environmental exposures. Multivariable analyses estimated adjusted odds ratios and adjusted incident rate ratios between clinical, demographic, and environmental risk factors and 30-day readmissions or CVC complications.RESULTSOf 222 patients, total parenteral nutrition was associated with increased 30-day readmissions (adjusted odds ratio, 4.80 [95% CI, 1.51–15.21) and CVC complications (adjusted odds ratio, 2.41 [95% CI, 1.09–5.33]). Exposure to soil through gardening or yard work was associated with a decreased likelihood of readmissions (adjusted odds ratio, 0.09 [95% CI, 0.01–0.74]). Other environmental exposures were not associated with CVC complications.CONCLUSIONScomplications and readmissions were common and associated with the use of total parenteral nutrition. Common environmental exposures (well water, cooking with raw meat, or pets) did not increase the rate of CVC complications, whereas soil exposures were associated with decreased readmissions. Interventions to decrease home CVC complications should focus on total parenteral nutrition patients.Infect Control Hosp Epidemiol 2016;1–8

Catheter-Related Vancomycin-ResistantEnterococcus FaeciumBacteremia: Clinical and Molecular Epidemiology

2005 ◽  
Vol 26 (7) ◽  
pp. 658-661 ◽  
Author(s):  
Issam I. Raad ◽  
Hend A. Hanna ◽  
Maha Boktour ◽  
Noel Jabbour ◽  
Ray Y. Hachem ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Parenteral Nutrition ◽  
Molecular Epidemiology ◽  
Total Parenteral Nutrition ◽  
Tertiary Care ◽  
Cancer Center ◽  
Care Hospital ◽  
Patients With Cancer ◽  
Vancomycin Resistant ◽  
Gastrointestinal Colonization

AbstractObjective:To study the clinical and molecular epidemiology of vancomycin-resistantEnterococcus faeciumorganisms causing catheter-related bacteremia in patients with cancer.Design:Retrospective case-control study.Setting:University of Texas M. D. Anderson Cancer Center, a tertiary-care hospital in Houston, Texas.Patients:Case-patients were patients with cancer who had catheter-related vancomycin-resistantE. faeciumbacteremia and control-patients were patients with cancer and vancomycin-resistantE. faeciumgastrointestinal colonization without infection.Results:Ten case-patients with catheter-related vancomycin-resistantE. faeciumbacteremia were compared with 30 control-patients with gastrointestinal colonization by vancomycin-resistantE. faecium. Patients with catheter-related vancomycin-resistantE. faeciumbacteremia were more likely to have required mechanical ventilation (P< .01), received total parenteral nutrition (P< .01), and had polyurethane catheters (P< .01) inserted in the femoral vein (P= .01). With the use of pulsed-fleld gel electrophoresis, 4 of the 10 catheter-related vancomycin-resistantE. faeciumbacteremia isolates were genetically indistinguishable, whereas only 2 of the 30 control vancomycin-resistantE. faeciumisolates displayed this same DNA pattern (P= .03).Conclusion:This study suggests that catheter-related vancomycin-resistantE. faeciumbacteremia occurs more frequently in patients who receive total parenteral nutrition, mechanical ventilation, and femoral catheters. (Infect Control Hosp Epidemiol 2005;26:658-661)

Catheter-Related Infections in a Canadian Home Total Parenteral Nutrition Program: A Prospective Study Using U.S. Centers for Disease Control and Prevention Criteria

2007 ◽  
Vol 12 (2) ◽  
pp. 85-88 ◽  
Author(s):  
Olivia Saqui ◽  
Maitreyi Raman ◽  
Albert Chang ◽  
Johane P. Allard
Keyword(s):  
Parenteral Nutrition ◽  
Prospective Study ◽  
Total Parenteral Nutrition ◽  
Infection Rate ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Home Parenteral Nutrition ◽  
Infusion Therapy ◽  
Coagulase Negative Staphylococcus ◽  
Nutrition Program

Abstract The most frequent home parenteral nutrition complication is central venous catheter infection. The authors sought to determine the rate and types of bloodstream infections in a Canadian home parenteral nutrition program. Methods: Bloodstream infection was diagnosed if all following criteria were present: (1) one or more positive blood cultures were found, (2) antimicrobial therapy or catheter was removed, and (3) there were no other infections. Results: Between April 1, 1996, and April 30, 1997, 43 patients from the Home Parenteral Nutrition Program at Toronto General Hospital participated in a multicenter study in which a total of 355 patients receiving home infusion therapy for various reasons were enrolled. From these 43 patients, there were 37 infections in 19 home parenteral nutrition patients. The infection rate was 2.3 per 1000 catheter days. The common infecting organism was coagulase-negative Staphylococcus. Conclusion: In this prospective study involving patients receiving home parenteral nutrition, although the information is 10 years old, the infection rate of 2.3 per 1000 catheter days is lower than most recent studies involving patients receiving total parenteral nutrition in the hospital or at home with a similar common infecting organism of coagulase-negative Staphylococcus.

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