Abstract
Background: Home parenteral nutrition (HPN) has become a common therapy. There is still controversy regarding the possibility that peripherally inserted central catheters (PICCs) may diminish catheter-related blood stream infection (CRBSI) rates. Methods: We searched the PubMed database for studies reporting the rates of CRBSI with HPN. Study selection was performed independently by three investigators. Disagreements were discussed and resolved by consensus or by arbitration by an author not involved in the search. The National Institutes of Health Quality Assessment Tools was used to assess the methodological quality of the studies. Meta-analyses were performed using MetaXL 5.3 with the quality effects model. Results: Screening of the article titles and abstracts yielded 134 full text articles for evaluation. Only three prospective studies that included appropriate data were considered for the final analysis. The relative risk of the CRBSI rate was 0.41 (0.14–1.17) for PICC vs. tunneled catheters. The relative risk of the CRBSI rate was 0.16 (0.04–0.64) for PICC vs. ports. The relative risk of the thrombosis rate was 3.16 (0.20–49.67) for PICCs vs. tunneled. Conclusions: There is insufficient evidence to show a difference in CRBSI rates between PICCs and tunneled catheters. On the other hand, PICCs showed lower CRBSI rates than ports. There was also no difference in the rate of catheter-related thrombosis and mechanical complications.
Highlights
In the last few years, parenteral nutrition has become a common therapy for patients at home and has been mainly driven by an increase in the proportion of adult patients with cancer who need this therapy [1,2]
There is insufficient evidence to show a difference in catheter-related blood stream infection (CRBSI) rates between peripherally inserted central catheters (PICCs) and tunneled catheters
In the present study we have shown that CRBSI rates were similar between PICCs and tunneled central catheters, fewer infections compared to ports in prospective studies
Summary
In the last few years, parenteral nutrition has become a common therapy for patients at home and has been mainly driven by an increase in the proportion of adult patients with cancer who need this therapy [1,2]. National registries in North America, including more than a thousand patients, showed that nearly 30% were expected to require home parenteral nutrition (HPN) indefinitely [3]. In Spain, a total of 308 patients were registered in 2017 from 45 centers with 3012 episodes, which represent a prevalence rate of 6.61 patients/million inhabitants/year, which is higher than in previous reports [1]. Home parenteral nutrition (HPN) has become a common therapy. Methods: We searched the PubMed database for studies reporting the rates of CRBSI with HPN.
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