Pediatric Intensive Care Unit, Children's Hospital, Université de Bordeaux, 33000 Bordeaux, France.
Department of Gastroenterology, Haut-Leveque Hospital, Université de Bordeaux, 33600 Pessac, France.
Nutrients. 2022 Jun 18;14(12):2532. doi: 10.3390/nu14122532.
Although central venous catheter (CVC)-related thrombosis (CRT) is a severe complication of home parenteral nutrition (HPN), the amount and quality of data in the diagnosis and management of CRT remain low. We aimed to describe current practices regarding CVC management in French adult and pediatric HPN centers, with a focus on CVC obstruction and CRT. Current practices regarding CVC management in patients on HPN were collected by an online-based cross-sectional survey sent to expert physicians of French HPN centers. We compared these practices to published guidelines and searched for differences between pediatric and adult HPN centers' practices. Finally, we examined the heterogeneity of practices in both pediatric and adult HPN centers. The survey was completed by 34 centers, including 21 pediatric and 13 adult centers. We found a considerable heterogeneity, especially in the responses of pediatric centers. On some points, the centers' responses differed from the current guidelines. We also found significant differences between practices in adult and pediatric centers. We conclude that the management of CVC and CRT in patients on HPN is a serious and complex situation for which there is significant heterogeneity between HPN centers. These findings highlight the need for more well-designed clinical trials in this field.
虽然中心静脉导管（CVC）相关性血栓形成（CRT）是家庭肠外营养（HPN）的严重并发症，但在 CRT 的诊断和管理方面，数据的数量和质量仍然很低。我们旨在描述法国成人和儿科 HPN 中心在 CVC 管理方面的当前实践，重点是 CVC 阻塞和 CRT。通过向法国 HPN 中心的专家医生发送在线横断面调查，收集了关于 HPN 患者 CVC 管理的当前实践。我们将这些实践与已发表的指南进行了比较，并寻找了儿科和成人 HPN 中心实践之间的差异。最后，我们检查了儿科和成人 HPN 中心实践的异质性。该调查由 34 个中心完成，包括 21 个儿科中心和 13 个成人中心。我们发现存在相当大的异质性，尤其是在儿科中心的回答中。在某些方面，中心的回答与当前指南不同。我们还发现成人和儿科中心之间的实践存在显著差异。我们的结论是，HPN 患者的 CVC 和 CRT 管理是一个严重且复杂的情况，HPN 中心之间存在显著的异质性。这些发现强调了在该领域进行更多精心设计的临床试验的必要性。
