Division of Gastroenterology and Hepatology, Seattle Children's Hospital, Seattle, Washington, USA.
Department of Pediatrics, University of Washington, Seattle, Washington, USA.
Nutr Clin Pract. 2023 Dec;38(6):1273-1281. doi: 10.1002/ncp.11047. Epub 2023 Aug 3.
Children with intestinal failure (IF) require long-term central venous access to provide life-sustaining parenteral nutrition. Mechanical, thrombotic, and infectious complications are potentially life-threatening and may necessitate central venous catheter (CVC) replacement. Repeated central line replacements may lead to a loss of vascular access sites and increases risk for intestinal transplantation. Children with IF face unique challenges for CVC safety given their young age, altered anatomy, and increased risk of thrombosis and infection. The following review addresses preventative, diagnostic, and treatment strategies for central line safety concerns specific to children with IF as well as recommendations for promoting catheter safety during activities, travel, and emergencies.
患有肠衰竭(IF)的儿童需要长期的中心静脉通路来提供维持生命的肠外营养。机械性、血栓性和感染性并发症可能危及生命,可能需要更换中心静脉导管(CVC)。反复更换中心静脉导管可能导致血管通路丧失,并增加肠移植的风险。由于儿童年龄较小、解剖结构改变以及血栓形成和感染的风险增加,他们在 CVC 安全性方面面临着独特的挑战。以下综述针对 IF 患儿的中心静脉安全问题,介绍了预防、诊断和治疗策略,以及在活动、旅行和紧急情况下促进导管安全的建议。