q A central VAD is mandatory for
home parenteral nutrition (HPN)
Venous access device (VAD)
q The choice of VAD depends on:
§ expected duration of therapies
§ clinical experience/expertise of the provider/staff
§ central VAD history
Which VAD for Home Parenteral Nutrition?
This is an open discussion
Why it is a
controversial
issue? - 1
q
Because there are many differences
in HPN management
in benign and oncology patients
Which VAD for Home Parenteral Nutrition?
Why it is a
controversial
issue? - 2
q
Because guidelines and position papers
of scientific societies
qCVCs most appropriate for PN therapy in the
home setting include peripherally inserted central catheters (PICC), tunneled catheters, and
v
Percentage of HPN cancer patients with the different VADs per year 0 10 20 30 40 50 60 70 80 At May 31, 2008 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 VA Ds ( % )
PICC NONTUNNELED TUNNNELED PORT
2015-16 PICC 71% NON TUNNELED 4% TUNNELED 9%
q There are important differences in
venous access and care concerning
benign versus oncology HPN patients
q Many factors may impact on the
choice of long-term, VAD, including patient preference
q Using bundles, PICC can be safely
