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Nutrition in Clinical Practice
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Invited Review: Catheter Infection Control in Parenteral Nutrition

Susan L. Cahill, M.D.

New England Deaconess Hospital, Boston

Peter N. Benotti, M.D.

Havard Medical School, Cambridge, Massachusetts

Catheter sepsis rates related to total parenteral nutrition are variable and depend on several patient-specific factors. These factors include the presence of immunosuppression or critical illness, the use of multiple intravascular catheters, and bacterial translocation. Catheter-related sepsis may present in the patient as fever, chills, change in mental status, hypotension, and leukocytosis. In patients with suspected catheter-related infection whose peripheral blood cultures do not grow the same organism as a blood culture drawn from the catheter, a guidewire exchange of the catheter has been shown to be effective. This technique should be considered a surgical procedure. Complications that are associated with guidewire exchange of central venous catheters are catheter malposition, embolism of air or septic thrombi, and cardiac arrhythmias.

Nutrition in Clinical Practice, Vol. 6, No. 2, 65-67 (1991)
DOI: 10.1177/011542659100600265
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