American Society for Parenteral and Enteral Nutrition Guidelines for the Selection and Care of Central Venous Access Devices for Adult Home Parenteral Nutrition Administration.

{"article_title":"American Society for Parenteral and Enteral Nutrition Guidelines for the Selection and Care of Central Venous Access Devices for Adult Home Parenteral Nutrition Administration.","author":"Kovacevich DS, Corrigan M, Ross VM, McKeever L, Hall AM, Braunschweig C","journal_title":"JPEN. Journal of parenteral and enteral nutrition","issn":"1941-2444","isbn":"","publication_date":"2019-01-01","volume":"43","issue":"1","first_page":"15","page_count":"","accession_number":"30339287","doi":"10.1002\/jpen.1455","publisher":"Wiley","doctype":"Practice Guideline","subjects":"United States; Catheter-Related Infections prevention & control; Catheterization, Central Venous instrumentation; Central Venous Catheters adverse effects; Equipment Failure; Infusions, Parenteral instrumentation; Parenteral Nutrition, Home instrumentation; Adult; Aged; Aged, 80 and over; Catheterization, Central Venous adverse effects; Enteral Nutrition; Humans; Middle Aged; Societies, Medical; United States","interest_area":["Internal Medicine"," Emergency Medicine"],"abstract":"This document represents the American Society for Parenteral and Enteral Nutrition (ASPEN) clinical guidelines to describe best practices in the selection and care of central venous access devices (CVADs) for the infusion of home parenteral nutrition (HPN) admixtures in adult patients. The guidelines targeted adults >18 years of age in which the intervention or exposure had to include HPN that was administered via a CVAD. Case studies, non-English studies, or studies of CVAD no longer available in the United States were excluded. In total, 564 abstract citations, 350 from Medline and 214 from PubMed\/non-MEDLINE databases, were scanned for relevance. Of the 564 citations, 13 studies addressed at least 1 of the 6 guideline-related questions, and none of the studies were prospective and randomized. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria were used to adjust the evidence grade based on assessment of the quality of study design and execution. Recommendations for the CVAD type, composition, or number of lumens to minimize infectious or mechanical complications are based on a limited number of studies and expert opinion of the authors, all very experienced in home infusion therapy. No studies were found that compared best solutions for routine flushing of lumens (eg, heparin versus saline) or for maintaining catheters in situ while treating CVAD mechanical or infectious complications. It is clear that studies to answer these questions are very limited, and further research is needed. These clinical guidelines were approved by the ASPEN Board of Directors. \u00a9 2018 American Society for Parenteral and Enteral Nutrition.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=30339287","isPdfLink":false,"isSAML":false,"an":"30339287","number_other":"","type_pub":"","issn_electronic":"1941-2444","languages":"English","language":"eng","date_entry":"Date Created: 20181020 Date Completed: 20200817 Latest Revision: 20240103","date_update":"20240103","titleSource":"JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2019 Jan; Vol. 43 (1), pp. 15-31. Date of Electronic Publication: 2018 Oct 19.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2019-01-01","description":"This document represents the American Society for Parenteral and Enteral Nutrition (ASPEN) clinical guidelines to describe best practices in the selection and care of central venous access devices (CVADs) for the infusion of home parenteral nutrition (HPN) admixtures in adult patients. The guidelines targeted adults >18 years of age in which the intervention or exposure had to include HPN that was administered via a CVAD. Case studies, non-English studies, or studies of CVAD no longer available in the United States were excluded. In total, 564 abstract citations, 350 from Medline and 214 from PubMed\/non-MEDLINE databases, were scanned for relevance. Of the 564 citations, 13 studies addressed at least 1 of the 6 guideline-related questions, and none of the studies were prospective and randomized. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria were used to adjust the evidence grade based on assessment of the quality of study design and execution. Recommendations for the CVAD type, composition, or number of lumens to minimize infectious or mechanical complications are based on a limited number of studies and expert opinion of the authors, all very experienced in home infusion therapy. No studies were found that compared best solutions for routine flushing of lumens (eg, heparin versus saline) or for maintaining catheters in situ while treating CVAD mechanical or infectious complications. It is clear that studies to answer these questions are very limited, and further research is needed. These clinical guidelines were approved by the ASPEN Board of Directors.<br \/> (© 2018 American Society for Parenteral and Enteral Nutrition.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&scope=site&db=mdl&AN=30339287&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Kovacevich DS, Corrigan M, Ross VM, McKeever L, Hall AM, Braunschweig C"}