Catheter Replacement Research Articles

Comparison of dwell time and complications between peripheral venous catheters and midline catheters in infants weighing ≥ 1500 g at birth.

Newborns in the neonatal intensive care unit (NICU) often require infusion therapy immediately after admission. In such cases, the catheter must be selected according to the condition of the neonate. The aim of this study was to compare the performance of a peripheral venous catheter (PVC) in terms of dwell time, number of catheter replacements required, and complication rate with that of a midline catheter (MC) in neonates weighing ≥1500 g and requiring care in a NICU. The study had a retrospective observational design and included neonates with a birthweight of ≥1500 g who were admitted to a level III NICU between April 2019 and May 2021 and received infusion therapy via a PVC or MC. Patient, maternal, and infusion-related data were collected from the medical records. The outcomes were compared between the PVC and MC groups according to type of catheter used. Univariate analyses of the infusion-related data demonstrated that neonates in the MC group (n = 52) had significantly longer dwell times, required fewer catheter replacements, and had a greater probability of completing therapy with less risk of extravasation than those in the PVC group (n = 54). These findings confirm that the MC has advantages over the PVC, including a longer dwell time, fewer catheter replacements, and less risk of extravasation in newborns with a birthweight of ≥1500 g.

The use of mini-invasive surgical techniques to treat refractory exit-site and tunnel infections in peritoneal dialysis patients: a clinical approach.

Peritoneal dialysis-(PD) related infections continue to be a major cause of morbidity and mortality in patients on PD. Although greatadvances have been made in the prevention and treatment of infectious complications over the past two decades, catheter-related infections represent asignificant cause of technical failurein PD. Recent studies support the role of exit-site/tunnel infections in causing peritonitis. Peritonitis secondary to tunnel infection led to catheter loss in most cases. Thus, removing the catheter when exit-site/tunnel infection is refractory to medical therapy has been recommended. This approach requires interrupting PD and, after the placement of a central venous catheter, andtransferring the patient to haemodialysis. In order to continue PD, simultaneous catheter removal and replacement of the PD catheter has been suggested. Although simultaneous catheter removal and replacement avoids temporary haemodialysis, it implies the removal/reinsertion of the catheter and the immediate initiation of PD with the risk of mechanical complications, such as leakage and malfunction. Hence, several mini-invasive surgical techniques, such as curettage, cuff-shaving, removal of the superficial cuff, and partial reimplantation of the catheter, have been proposed as rescue treatments. These procedures mayallow the rescue of the catheter with a success rate of 70-100%. Therefore, in case of refractory exit-site/tunnel infection, a mini-invasive surgical revision should be considered before removing the catheter.

Tunneled Central Venous Catheters in Young Children: Complication Profile Can Guide Choice of Line

IntroductionPlacement of tunneled central venous catheters (CVCs) is one of the most common procedures performed in children and can either be externally accessed or internally accessed. However, there are no data-driven guidelines on when to offer each line type, particularly in small children aged less than 5 y. Our hypothesis is that the two types of lines have different complication profiles and indications that can guide providers and families in this decision. MethodsA single-institution retrospective chart review was performed for patients aged less than 5 y who underwent initial placement of a tunneled CVC between 2014 and 2016. Patients were included if they underwent initial tunneled CVC placement within the study period and were excluded if line was emergently placed for hemodynamic instability or was a replacement catheter. Data were compared by type of CVC, weight more than or less than 10 kg, indications for CVC, complications, and duration of catheter. ResultsWe identified 148 patients who underwent initial tunneled CVC during study period. Seventy one patients (48%) received an externally accessed type and 77 (52%) received internally accessed type. The indications for line placement were TPN in 24 patients (16%), chemotherapy in 67 (45%), vascular access in 45 (31%), and nonchemotherapy infusions in 12 (8%). Externally accessed catheters had higher late complications (> 30 d) in patients > 10 kg compared to internally accessed catheters (63% versus 21%, P < 0.01). ConclusionsWhile some diagnoses determine line type, there are other indications that may qualify patients for either line. Our data demonstrate a lower long-term complication rate with internally accessed catheters and suggest they be considered over externally accessed lines in appropriate patients.

Application of Percutaneous Transluminal Angioplasty in the Replacement of Tunnel-Cuffed Catheter in Maintenance Hemodialysis Patients

Application of Percutaneous Transluminal Angioplasty in the Replacement of Tunnel-Cuffed Catheter in Maintenance Hemodialysis Patients

Efficacy of same venous route Hickman catheter replacement in patients with intestinal failure

Periodical replacement of venous Hickman catheters is required for the nutritional care of patients with intestinal failure. The conventional de novo operation (DN-OP) involves inserting the catheter into a new venous tract in each replacement; however, this could result in fast consumption of functional central vessels in patients with intestinal failure. Recently, same-route operation (SR-OP) has been adopted as an alternative approach for retaining venous access. We conducted a retrospective study to compare the efficacy of Hickman catheters and the survival of venous vessels using two different operative strategies. Overall, 181 catheters were inserted, 109 using DN-OP and 72 using SR-OP. The mean catheter duration was 11.9±8.8 months in the DN-OP group and 10.5±5.6 months in the SR-OP group; the infection rate was 0.74 in the DN-OP group and 0.44 in the SR-OP group. The vein accesses used in these insertions (n=113) were classified: the DN-vein group for veins accessed only by DN-OP (n=75) and the SR-vein group for veins accessed by an initial DN-OP and subsequent SR-OPs (n=38). Mean working duration per vein access was 12.3±10.1 months in the DN-vein group and 28.2±14.8 months in the SR-vein group (p<0.001); mean infection-free duration was 11.4±10.1 months in the DN-vein group and 27.7±15.3 months in the SR-vein group (p<0.001). Application of SR-OP in Hickman catheter replacement significantly extended the working duration of venous access by re-using the same venous route without compromising catheter efficacy in patients with IF having poor venous access.

Ureteral Obstruction Due to Inadvertent Placement of the Suprapubic Catheter and Bladder Indwelling Catheter: Presentation of Two Clinical Cases and Review of the Literature

Introduction: Suprapubic catheter (SPC) and bladder indwelling catheter (BIC) placement are among the most common urological procedures. Inadvertent misplacement of the catheter tip into the ureteral orifice is an infrequent event with potentially critical complications. Case Presentation: We describe two cases of inadvertent intraureteral misplacement of an SPC and a BIC. A 66-year-old man with chronic kidney disease (CKD) stage G3b, urethral stenosis, long-term SPC who attended the emergency room (ER) 6 hours after the last catheter replacement due to low back pain, fever, deterioration of the general condition, anuria, acute kidney injury (AKI); CT-scan revealed a left uretero-hydronephrosis secondary to obstruction of the catheter balloon misplaced inside the distal ureter. A 59-year-old woman with CKD stage G3b, post-radiotherapy cystitis, and small capacity bladder, long-term BIC who attended the ER a few hours after the last BIC replacement due to abdominal pain, anuria, AKI; CT-scan revealed left hydronephrosis secondary to catheter obstruction within the distal ureter. In both patients, management was conservative, consisting of removing the catheter and repositioning it inside the bladder, in addition to hydration and antibiotherapy. Conclusions: These cases illustrate that awareness of this rare complication can be prevented by confirming the correct positioning of SPC or BIC after its replacement. Early detection and management of this complication can prevent a serious clinical setting.

Incidence, Risk Factors and Prevention Related to Infusion Phlebitis

Phlebitis linked with peripheral venous catheters is caused by inflammation of the vein at the cannula access site. It could be caused by mechanical, chemical, or pathogenic agents. Phlebitis can be avoided by adhering to best practises when inserting a cannula, such as selecting the right device and placement. Document the incidence of phlebitis and explore the risk factors linked with it. Analysis of existing data from a major randomised controlled trial. The primary goal of which was to compare routine peripheral intravascular catheter replacements with catheter replacements based solely on clinical indication. Patients hospitalised to the medicine and surgery ward, which required an intravenous catheter in the periphery were the part of study. 13283 PIVCs were investigated. During intravenous infusion, 41 (0.1%), and 48 hours after chemotherapy infusion, 35 (1.3%), paediatric patients were diagnosed with phlebitis. Postinfusion phlebitis can be problematic; therefore, it is essential for medical professionals to inform patients of what to watch for after the removal of an intravascular device.

Factors associated with postoperative urinary retention in patients undergoing penile prosthesis implantation.

Placement of penile prosthesis had been well described in the outpatient setting, however, one barrier to same-day discharge is postoperative urinary retention (POUR). POUR remains a condition encountered during ambulatory surgical procedures and has yet to be characterized in patients undergoing penile prosthesis. We characterized POUR in a cohort of penile prosthesis recipients along with risk factors and management. Patients undergoing penile prosthesis implantation from 2014 through 2020 without pre-existing retention were included. All patients underwent a void trial immediately following penile prosthesis in the post-anesthesia care unit. POUR was strictly defined as (1) any patient requiring catheter replacement after prosthesis, (2) a rising post-void residual, or (3) inability to void after 6 h regardless of whether a catheter was placed. Independent procedures, demographic, intraoperative, and postoperative risk factors for POUR were assessed. 317 men were included of whom 27.1% experienced POUR. Men experiencing POUR and those not in retention were essentially indistinguishable with respect to previously described risk factors for POUR. Only use of both α-blockers and 5-α-reductase inhibitors was significantly associated with a greater risk of POUR, a finding maintained on adjusted analysis (adjusted odds ratio 10.1, 95% confidence interval 2.1 to 49.8). POUR resolved without intervention in 3.5%, a single episode of clean intermittent catheterization (CIC) in 7.0% of patients, and repeated CIC or indwelling catheter placement with a successful delayed void trial in 88.4% of patients. Rate of prosthesis infection in patients who experienced POUR did not significantly differ from those who did not experience POUR (4.7% vs. 2.2% p = 0.26). Our findings suggest that POUR is experienced in as many as 1 in 4 men undergoing penile prosthesis placement, most of whom must be managed with indwelling catheterization or repeated CIC. Those with indicators of symptomatic prostate enlargement are at significantly greater risk of urinary retention.

Self Amputation of the Penis to a Schizophrenic Patient: A Case Report

Introduction: We present a rare case of complete self-amputation of the penis to a patient followed for schizophrenia under neuroleptic. Case Presentation: A 44 years old patient, schizophrenic under neuroleptic, who presents following an almost total section of his penis 48 hours after his self-mutilation. After having ruled out a life-threatening emergency, hemostasis control with urethral catheterization was carried out in the operating room and then phallic replacement may be indicated to the patient after psychological stabilization. Discussion: The section of the penis is a rare urological emergency that requires a fast surgical catch and can be classified into 3 groups: self-mutilation, criminal amputation or traumatic accident. Schizophrenia and depression represent the two most common causes of psychosis. Iatrogenic amputations of the penis have been described in the literature secondary to circumcisions. Surgical management is based on emergency reimplantation of the penis, section with placement of a urethral catheter or phallic replacement. Conclusion: The section of the penis is a rare urological emergency and the choice of treatment depends on the severity of the lesions and the consultation time.

Kalıcı tünelli veya geçici hemodiyaliz kateteri ile rutin hemodiyaliz programında olan hasta grubunda kateter tipine göre Maliyet-Etkinlik araştırması

Abstract&#x0D; Background:&#x0D; In this study, our aim was to conduct a cost/effectiveness research by determining the cost , in the patients who are in the routine hemodialysis program with a hemodialysis catheter, according to type of the catheter and the number of the days in which the catheters can be used actively.&#x0D; Methods:&#x0D; Between 2013 and 2020,patients with temporary hemodialysis catheters (Group 1 , n:81) and patients tunneled hemodialysis catheters (Group 2, n:205) were identified by scanning the hospital archive. The number of days in which the catheters were actively used was calculated according to the next catheter insertion or replacement date. Then, the permanent and temporary catheter fees paid by the governmentdetermined, according to the current Health Practices Communique (SUT) pricing that learnt from the hospital accounting department. Catheter cost per day was determined using the SPSS 22 program.&#x0D; Results:&#x0D; In the analysis made according to demographic characteristics, no significant difference was found between the groups in terms of gender (p=0.129). When the mean age of the patients was examined, no difference was found between the groups (p=0.085). No statistical difference was found between the groups in comorbid conditions: diabetes, hypertension, and coronary artery disease (p=0.219, p=0.129, p=0.822). The patency period was significantly higher in group 2 (p

Risk Factors for Mortality in Patients with Stenotrophomonas maltophilia Bloodstream Infections in Immunocompetent Patients.

This study aimed to evaluate bloodstream infections caused by Stenotrophomonas maltophilia in immunocompetent patients with respect to clinical features and risk factors for mortality. We reviewed bloodstream infections detected between January 1, 2012, and July 1, 2021, to identify nosocomial S. maltophilia bacteremia in Koşuyolu Research and Training Hospital. We identified a total of 97 patients with S. maltophilia bloodstream infections. Of these, 17 patients were excluded because of community-acquired infections (n=9), contamination with S. maltophilia (n=3), and insufficient data (n=5), with 80 (57.5% males) patients remaining for analysis. The source of infection was the respiratory tract in 28 (35%) patients. A central venous catheter was used in 60 (75%) patients, which required replacement in 23 patients within five days after detecting S. maltophilia bacteremia. On antimicrobial susceptibility testing, 71 strains were found to be susceptible and 9 (11.3%) resistant to trimethoprim-sulfamethoxazole. Thirty-day mortality was 33.8%. Non-survivors differed significantly from survivors with respect to higher rates of central venous catheters ( p=0.020), mechanical ventilation (p=0.006), urinary catheters (p=0.021), septic shock (p=0.001), hypoalbuminemia (p=0.026) and thrombocytopenia (p =0.039). S. maltophilia bacteremia was independently associated with mortality in patients with hypoalbuminemia, and replacement of central venous catheters had a protective role in reducing mortality. As with other bacterial infections, S. maltophilia bacteremia is associated with a considerably high mortality rate in patients with cardiac conditions. The replacement of the catheter seems to play a beneficial role in 30-day survival.

Current material engineering strategies to prevent catheter encrustation in urinary tracts.

Catheters and ureteric stents have played a vital role in relieving urinary obstruction in many urological conditions. With the increasing use of urinary catheters/stents, catheter/stent-related complications such as infection and encrustation are also increasing because of their design defects. Long-term use of antibiotics and frequent replacement of catheters not only increase the economic burden on patients but also bring the pain of catheter replacement. This is unfavorable for patients with long indwelling catheters or stents but inconvenient to replace. In recent years, some promising technologies and mechanisms have been used to prevent infection and encrustation, mainly drug loading coatings, functional coatings, biodegradable polymers and metallic materials for urinary devices. Obvious effects in anti-encrustation and anti-infection experiments of the above strategies in vivo or in vitro have been conducted, which is very helpful for further clinical trials. This review mainly introduces catheter/stent technology and mechanisms in the past ten years to address the potential impact of anti-encrustation coating of catheter/stent materials for the prevention of encrustation and to analyze the progress made in this field.

Chylopericardium or contamination by injectable lipid emulsion?

Effusions can show some surprises. We document the case of a fourteen-month-old male patient with short-bowel syndrome, hospitalized in a cardiology unit, receiving a chronic parenteral nutrition by a Broviac® catheter. The patient presented several thrombosis following iterative catheter replacements. In parallel with superior vena cava plasty, a right intra-atrial Broviac® catheter was placed in the absence of other peripheral venous accesses. This device has a cutaneous exit site to allow for infusion of a hyperosmolar lipid emulsion. Seven days later, a milky liquid was secreted from pericardial/mediastinal redon. A gel lipoprotein electrophoresis of the fluid suggested a preliminary diagnosis of chylopericardium. However, biochemical testing of certain analytes evoked a parenteral nutrition-related pericardial effusion and a possible pseudochyloperitoneum caused by the shearing of a migrated Broviac® in pericardium. The patient, on a fat-free diet, was admitted to the ICU to drain the effusion and reposition the catheter, with success. In the light of new datas on the interference of parenteral lipid emulsions with the lipoproteins gel electrophoresis, we will try to determine whether the apparent presence of chylomicrons in the gel would be the sign of a lesion of the lymphatic system, or rather the result of a contamination by artificial chylomicron in the lipid emulsion, if not the sign of contaminated blood. In our article, we highlight several considerations in identifying and confirming cases of pericardial effusion, such as chylopericardium and parenteral nutrition-related one, as well as points concerning the use of lipid emulsions for pediatric patients with short-bowel syndrome.

Epidural catheter replacement rates with dural puncture epidural labor analgesia compared with epidural analgesia without dural puncture: a retrospective cohort study

BackgroundLumbar epidural analgesia (LEA) is commonly used for labor analgesia but up to 13% of epidural catheters fail and require replacement. Combined spinal-epidural analgesia is associated with a lower catheter failure rate. Few data exist regarding catheter replacement rates after dural-puncture epidural (DPE). We conducted a retrospective analysis comparing catheter failure rates between epidural and DPE techniques. MethodsThis retrospective single-center trial reviewed all labor neuraxial analgesia procedures among 18 726 women across five years, and identified 810 DPE and 2667 LEA procedures. Catheter failure rates, consisting of replacement or requirement of general anesthesia for cesarean delivery, were compared. Propensity score matching was used to balance the groups. ResultsDural-puncture epidural was associated with significantly fewer catheter failures compared with LEA (74/759 vs. 49/759, odds ratio 0.64, 95% CI 0.44 to 0.93, P=0.02). Sensitivity analysis excluding cases of general anesthesia confirmed this relationship. Risk factors identified for catheter failure included age, body mass index, and nulliparity. Dural-puncture epidural was associated with a longer mean time to catheter replacement (918 min vs. 609 min, P=0.04). Kaplan-Meier and Cox multivariate analyses confirmed this relationship. There was no significant difference in the requirement for epidural analgesia supplementation, but DPE required supplementation significantly later than LEA. There was no difference in the rate of headache or epidural blood patch between groups. ConclusionsDural-puncture epidural is associated with fewer catheter failures and replacements than LEA, without an increase in the rate of post-dural puncture headache or epidural blood patch.

Beware of a duplicate superior vena cava

A duplicate superior vena cava (SVC) with a persistent left SVC (PLSVC) is present in 0.3% of the population with an incidence as high as 10-11% in patients with congenital heart disease. While a PLSVC is rare and usually asymptomatic, clinicians should be aware of this anomaly during central line placement due to potential complications. Our case involves a 76-year-old man with end-stage renal disease, on peritoneal dialysis (PD), who was admitted to our hospital for treatment of generalized peritonitis secondary to a descending colon perforation. He underwent left hemicolectomy and removal of an infected PD catheter. During preparation for discharge, he underwent hemodialysis catheter replacement. During the procedure, it was noted that the wire did not traverse the midline. A subsequent venogram with contrast showed a duplicate SVC draining into the coronary sinus. The catheter was inserted into the proximal left SVC and verified with fluoroscopy. One hour later, the patient went into atrial fibrillation and death ensued. Persistent superior vena cava, if known or suspected, requires additional caution in central venous line placement to avoid potentially fatal complications, such as arrhythmias. Immediate removal and reassessment of an alternative access site should be pursued to avoid secondary complications.

Appropriate management reduces radiation exposure in daily urological practice.

To identify and raise awareness of the radiation exposure of urologists due to X-ray fluoroscopic procedures in daily practice. This was a single-center, cohort study of 30 consecutive patients who underwent periodic percutaneous or transurethral replacements of urinary tract catheters. A total of 55 replacements every 3 months with cases aligned were performed by a single urologist. The urologist's radiation exposure and the incident dose to patients per case were measured with thermoluminescent dosimeters. In the latter 3-month period, the pulse fluoroscopy condition was changed from 15 to 7.5 pulses per second, and collimation was added to the field of view. In the analysis of all patients, the use of a modified pulse rate and collimation did not affect the fluoroscopy time, but it did significantly reduce the air kerma and dose area product; in addition, with respect to the medical exposure dose during percutaneous catheter replacement, fluoroscopy time was longer, but air kerma and dose area product showed significant decreases. As with decreases in medical exposure of patients, the equivalent dose for eye lenses of the urologist decreased from 1.2 mSv in the first 3-month period to 0.2 mSv in the second 3-month period. Similarly, the exposure dose for the extremities also decreased significantly, from 33.9 mSv to 8.1 mSv. Urologists are exposed to non-negligible amounts of radiation due to fluoroscopy. Appropriate management such as modified pulse fluoroscopy condition and precautions are required.

Simultaneous replacement and removal of the peritoneal catheter is effective in patients with refractory tunnel infections sustained by S. aureus.

In tunnel infection (TI) refractory to medical therapy or in case of TI that occurs simultaneously with peritonitis, the removal of the peritoneal catheter has been proposed. This approach requires the interruption of peritoneal dialysis (PD) and the creation of a temporary vascular access. However, simultaneous removal and reinsertion of the PD catheter (SCR) represents another possible therapeutic approach. We analysed the outcome of 20 patients (10 men and 10 women, mean age 65.5 ± 16.3years) treated by CAPD for a mean period of 24.3 ± 14.2months who underwent to SCR for the treatment of TI unresponsive to medical therapy or TI that occurred simultaneously with peritonitis at Fondazione Ca' Granda Ospedale Maggiore Policlinico. All the patients restarted CAPD exchanges within 24h from catheter placement. SCR was successful in 80% (16/20) of the cases. In particular, SCR was effective in 100% (11/11) of the TI with or without associated peritonitis sustained by S. aureus. However, SCR failed in 57% (4/7) of TI associated with relapsing peritonitis and in one patient with TI secondary to Enterobacter. No early mechanical complications (within 3months after SCR) occurred when CAPD was restarted. SCR of the PD catheter through double-purse string technique represents an effective treatment for TI without or with simultaneously peritonitis sustained by S. aureus avoiding the patient the need for temporary hemodialysis and second surgical procedure. However, SCR could be contraindicated in case of relapsing peritonitis.

Uretero-Iliac Artery Fistula

Uretero-Iliac Artery Fistula: a rare cause of haematuria A 90-year-old male presented to our hospital with a onemonth history of intermittent gross hematuria. He had stage II rectal cancer and received neo-adjuvant concurrent chemoradiotherapy and low anterior resection 5 years ago. Additionally, he was under regular bilateral ureteral catheter replacement due to radiation related ureteral stricture for two years.\r\nDuring examination, there was no abdominal tenderness or flank pain. Urine analysis showed pyuria and hematuria. Abdominal and pelvic computed tomography without contrast medium revealed only bilateralwithout contrast medium revealed only bilateral hydronephrosis. After admission, several hematuria episodes that required blood transfusions and bladder irrigation occurred at an interval of 3 days and resolved spontaneously. Cystoscopy was unmarkable except bleeding from right ureteral orifice during ureteral stent replacement. Concerns for a ureteral arterial fistula prompted an angiogram, which later on proved the existence of a fistula with pseudoaneurysm(Figure 1) between external iliac and distal right ureter(Figure 1). A stent graft was placed from the common iliac into the right external iliac artery. After stent-graft deployment, the aneurysm is no longer opacified. At the 2-month follow-up, no hematuria recurrence was detected.\r\n

A nationwide prospective multicenter study of external ventricular drainage: accuracy, safety, and related complications.

External ventricular drainage (EVD) catheters are associated with complications such as EVD catheter infection (ECI), intracranial hemorrhage (ICH), and suboptimal placement. The aim of this study was to investigate the rates of EVD catheter complications and their associated risk factor profiles in order to optimize the safety and accuracy of catheter insertion. A total of 348 patients with urgently placed EVD catheters were included as a part of a prospective multicenter observational cohort. Strict definitions were applied for each complication category. The rates of misplacement, ECI/ventriculitis, and ICH were 38.6%, 12.2%, and 9.2%, respectively. Catheter misplacement was associated with midline shift (p = 0.002), operator experience (p = 0.031), and intracranial length (p < 0.001). Although mostly asymptomatic, ICH occurred more often in patients receiving prophylactic low-molecular-weight heparin (LMWH) (p = 0.002) and those who required catheter replacement (p = 0.026). Infectious complications (ECI/ventriculitis and suspected ECI) occurred more commonly in patients whose catheters were inserted at the bedside (p = 0.004) and those with smaller incisions (≤ 1 cm) (p < 0.001). ECI/ventriculitis was not associated with preinsertion antibiotic prophylaxis (p = 0.421), catheter replacement (p = 0.118), and catheter tunneling length (p = 0.782). EVD-associated complications are common. These results suggest that the operating room setting can help reduce the risk of infection, but not the use of preoperative antibiotic prophylaxis. Although EVD-related ICH was associated with LMWH prophylaxis for deep vein thrombosis, there were no significant clinical manifestations in the majority of patients. Catheter misplacement was associated with operator level of training and midline shift. Information from this multicenter prospective cohort can be utilized to increase the safety profile of this common neurosurgical procedure.

Infection Prevention and Management in Pediatric Short Bowel Syndrome.

Short bowel syndrome (SBS) is a rare disease with potentially life-threatening consequences. In addition to intestinal failure-associated liver disease, infections and other complications related to central venous catheters (CVCs) cause a significant burden to patients with SBS and may even necessitate an intestinal transplant eventually. The need for long-term central venous access and the intestinal dysfunction associated with SBS drive the need for intestinal failure-specific approach to prevent and treat infections in patients with SBS. In bacterial infections, the line can often be salvaged with proficient antibiotic therapy. Repeated catheter replacements are predisposed to recurrent infections and thrombotic complications, which may limit the long-term survival of patients with SBS. Protocol-based CVC access procedures and daily care including taurolidine and ethanol catheter locks have been shown to reduce infection rates substantially. Compromised intestinal function in SBS predisposes to small bowel bacterial overgrowth, mucosal injury, and increased permeability. These pathophysiological changes are concentrated in a subset of patients with excessive bowel dilatation and frequent bowel-derived infections. In such patients, reconstructive intestinal surgery may be indicated. Probiotics have not been effective in infection prevention in SBS and carry a significant risk of complications. While more studies focusing on the prevention of infections and their complications are needed, protocol-based approach and multidisciplinary teams in the care of patients with SBS have been shown to reduce complications and improve outcomes.