Catheter-related infections with parenteral nutrition

Parenteral nutrition can be a lifesaving therapy in patients with intestinal failure, but the oral or enteral route is preferred when providing nutrition support ( when the gut works, use it ). Compared with PN, enteral nutrition generally is associated with fewer infectious complications (e.g., pneumonia, intraabdominal abscess, and catheter-related infections) and potentially improved outcomes.1-3 However, if used in appropriate patients (i.e., patients with questionable intestinal function or when the intestine cannot be used), PN can be used safely and effectively and may improve nutrient delivery.4 Indications for PN are listed in Table 97-1.1... 

Aguilella Vizcaino MJ, Valero Zanuy MA, Gastalver Martin C, Gomis Munoz P, Moreno Villares JM, Le6n Sanz M. Incidence of catheter-related infection and associated risk factors in hospitalized patients with parenteral nutrition. [Article in Spanish] Nutr Hosp 2012 May-Jun 27(3) 889-93. 

HIV-positive subjects are expected to be at even greater risk of line-related infection. A prospective study of 212 subjects with HIV infection with 327 central venous catheters has provided evidence of this enhanced risk (36). Over the period 1994-97, 33% were suspected as being infected, although only 61 episodes were diagnosed as catheter-related sepsis. Three variables affected the rate of sepsis parenteral nutrition, low numbers of circulating CD+ cells, and a high Apache score. 

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