Obtaining and maintaining vascular access in the home parenteral nutrition patient.

Obtaining and maintaining vascular access is a critical part of successful home parenteral nutrition (HPN) management. Most of the HPN related rehospitalization of patients is caused by problems associated with long-term vascular access. The causes of death in HPN patients are mostly related to their primary underlying disease. However, approximately 12% of deaths in HPN patients are related to catheter-associated problems. The appropriate placement of long-term vascular access devices and their care and management should be familiar to all clinicians helping to manage these patients and will be discussed.