Usefulness of central venous catheter replacement with a guidewire in patients with intestinal failure: a single-center study
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Aug 2024 · 1 min read
In brief
In brief
This single-center retrospective study evaluated guidewire replacement (GWR) as a method for exchanging central venous catheters in 108 intestinal failure patients requiring long-term parenteral nutrition. The GWR technique achieved a 94.4% success rate with significantly longer time to first infection compared to primary placement, demonstrating it as a safe and effective alternative that does not increase infection risk.
- Guidewire replacement (GWR) of CVCs in intestinal failure patients achieved 94.4% success rate with minimal complications.
- Time to first infection was significantly longer with GWR compared to primary placement (p=0.001).
- GWR method did not increase catheter replacement frequency or infection rates versus new venipuncture placement.
- Catheter survival rates were equivalent between GWR and primary placement methods in this 10-year single-center study.
- GWR offers a safe, effective alternative to new venipuncture for CVC replacement in long-term parenteral nutrition patients.
Written by the GCMD Library team from the article.
Abstract
Purpose
Patients with intestinal failure (IF) require long-term parenteral nutrition using central venous catheters (CVCs), which often require replacement. We adopted a less fallible guidewire replacement (GWR) method and verified its effectiveness and validity.
Methods
We enrolled 108 cases that underwent a CVC replacement with “GWR” method with IF at our department between 2013 and 2023. We retrospectively reviewed patients’ clinical details with tunneled CVC (Hickman/Broviac catheter). For the analysis, we compared for the same time period the catheter exchange method “Primary placement”; newly inserted catheter by venipuncture.
Results
The success rate of catheter replacement using GWR was 94.4%. There were six unsuccessful cases. A log-rank test showed no significant difference in catheter survival between primary placement and the GWR, and the time to first infection was significantly longer in the GWR (p = 0.001). Furthermore, no significant differences were observed between the two methods until the first infection, when the exchange indication was limited to infections. In the same way, when the indication was restricted to catheter-related bloodstream infection, there was no significant difference in catheter survival between the two approaches.
Conclusion
Our GWR procedure was easy to perform and stable, with a high success rate and almost no complications. Moreover, using a guidewire did not increase the frequency of catheter replacement and the infection rate.