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

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