ABSTRACT
Vascular access for parenteral nutrition support at home is a challenging and complex facet of the overall therapy. Diligent maintenance and care of the access site and device by the patient or home caregiver is vital in reducing catheter related complications, extending device life, reducing hospitalizations, and improving quality of life. Home parenteral nutrition (HPN) formulations are usually hyperosmolar in order to provide the nutrients and electrolytes the patient requires. The large vessels of the central venous system have the high blood flow necessary to dilute the HPN solution and prevent venous damage. Prior to CVC insertion, careful patient assessment by the clinical insertion team helps to ensure successful placement. In addition, discussion with the patient and caregiver should include age, ability to care for self, body image, length of therapy, lifestyle characteristics, and caregiver availability. Dialogue between the patient, caregivers, and clinicians will ensure the patient receives the device most suited to their lifestyle.
