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LITRE’S
catheter occlusion survey.
One of LITRE’s projects in 2003 was a survey
to access the prevalence of line blockages in Home Parenteral
Nutrition (HPN) catheters and the methods used to try
to prevent and resolve the problem. Below is the abstract
of the results which have caused a lot of interest and
hopefully this project will be the basis of further
work. Thank you to everyone who helped by completing
the questionnaire.
Blockage of a HPN catheter is a common problem reported
to the LITRE committee. The aim of the survey was to
determine if catheter occlusion is more common in HPN
patients infusing lipid, flushing the catheter with
saline (rather than heparin), or having no heparin in
the parenteral feeding bag.
A questionnaire was sent to all PINNT members having
parenteral nutrition and to the two Intestinal Failure
Units at Hope Hospital and St Mark’s. The questions
were about line blockage, lipid infusion, line flushing,
the addition of heparin to the PN bag, and methods to
treat line blockage.
Of the 360 questionnaires, 103 (29%) were returned.
Line occlusion was reported in forty-five (44%).
| |
No Occlusion |
Occlusion |
Lipid
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30 |
27 |
Separate lipid
|
9 |
11 |
| No lipid |
19 |
7* |
| The table shows the effect of Lipid
on line occlusion |
*p=0.06 |
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Line occlusion occured in 5, 13 and 24 patients
using heparin, using saline or a saline then heparin
flush after the PN infusion respectively, compared
with 12, 14 and 25 without. Of thirty-two who
had heparin added to their PN bag line occlusion
occurred in ten compared with thirty-three of
sixty-five (51% having no heparin in the bag (p=0.05).
Of those forty-five who had a blockage, thirty-five
(78%) took no precautions to prevent blockage
though six out of ten used an alcohol flush.
In conclusion, occlusion of an HPN catheter is
common and patients who do not infuse lipid may
have fewer line occlusions than those who infuse
it separately or in an all-in-one bag. Patients
who have heparin added to their PN bag may also
have fewer line occlusions. Randomised prospective
controlled studies are needed to further investigate
the role of lipid infusions, non-heparin flushing
of the catheter and the addition of heparin to
PN bags. |
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