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Central venous catheter related sepsis in children on parenteral nutrition: A 21-year single-center experience

Hojsak, Iva, Strizić, Helena, Mišak, Zrinjka, Rimac, Irena, Bukovina, Gordana, Prlić, Hrvoje, Kolaček, Sanja
Clinical nutrition 2012 v.31 no.5 pp. 672-675
catheters, children, parenteral feeding, patients, septic shock
BACKGROUND & AIMS: The aim was to assess the rate of central venous catheter (CVC) related sepsis in patients on parenteral nutrition (PN) at our hospital center during a period of 21 years. METHODS: Data on all children hospitalized at our tertiary hospital center during the 1989-2010 period, who received PN for more than 4 weeks (n = 62) were retrospectively analyzed. RESULTS: The mean age at the time of introducing PN was 2.9 years (range 6 days–17.4 years), male/female ratio 26/36. Out of these 62 patients, nine (14.5%) patients continued home PN (HPN) after discharge from the hospital. Altogether 86 CVCs were used (mean 1.39 per patient) and total CVC time was 21,459 days, which makes 243.9 days per CVC. During the study period, there were 36 CVC related sepsis episodes (1.7/1000 days of PN). Total number of septic episodes was significantly lower in HPN compared to hospital PN (0.94/1000 vs. 2.75/1000 days of PN; P < 0.001). Septic episodes led to removal of 11 (12.8%) catheters. Two patients died due to CVC related septic shock (0.93 deaths/10,000 days of PN), one in HPN patient (0.79 per 10,000 days of HPN). CONCLUSION: The rate of CVC related sepsis in our PN cohort was exceptionally low in both hospital and home setting.