Catheter-related complications in 35 children and adolescents with gastrointestinal disease on home parenteral nutrition.

A 7-year experience with home parenteral nutrition (HPN) in 35 children and adolescents suffering from severe gastrointestinal diseases is reported. The average duration of HPN was 577 days with a mean of 2.9 catheters per patients. There was a total of 82 episodes of proven catheter-related sepsis, an average of 1.5 septic episodes per patient year. In about half of these instances, the catheter had to be removed. Coagulase-negative and -positive staphylococci were the most common organisms isolated. All four Candida infections led to removal of the catheter. Children requiring HPN from early infancy had a higher frequency of catheter-related infections than those started on HPN after the first year of life. In four cases, clinically significant thrombotic complications occurred. The results suggest that even under optimal conditions of catheter placement and with extensive education in aseptic catheter handling, infection is still relatively common in children receiving HPN. However, there was no mortality related to this complication.