Central Venous Access in Children with Intestinal Failure
Patient Guideline Summary
- Intestinal failure occurs when the digestive system cannot nourish the body.
- As a result, patients with intestinal failure must be nourished parenterally (directly into the blood circulation).
- Access must be through large (central) veins that are capable of handling the nutritional liquids.
- The major complications to avoid are infection and blood clotting in the access vein.
- The most common causes of intestinal failure are intestinal disease or trauma that requires surgical removal of large amounts of the bowel.
- Symptoms are the result of malnutrition.
- This patient summary focuses on maintaining intravenous access in children requiring parenteral nutrition because of intestinal failure.
- Preferred veins are in the arms.
- Expertise is required for establishing and maintaining access, ideally within or with consultation from centers that also perform intestinal transplants.
- All caregivers, both in hospital and at home, must be thoroughly acquainted with proper procedures for managing access.
- Blood clots and infections should be treated immediately in the hospital.
- Routine surveillance is accomplished with ultrasound imaging.
- Supplies and instructions for emergencies must be available.
- A fever requires hospitalization.
- Activities must be planned to protect the access devices.
- Travel, swimming, and other sports require special preparations.
- The ultimate treatment for intestinal failure is intestinal transplantation.