Abstract
Search: Searches were performed in three stages. First, all the titles on the relevant key words were retrieved by the Cochrane Collaboration Department from Budapest/Hungary, who also performed the first reduction.
Members of the Working Group subsequently read all the titles and abstracts, and selected potentially relevant ones. These were retrieved and full articles were assessed.Securing reliable venous access is of paramount importance when considering parenteral nutrition (PN).
However, the presence of a central venous catheter (CVC) is the principal risk factor for major, potentially lethal complications, such as nosocomial bloodstream infection and venous thrombosis. Moreover, the most important risks associated with complications arising from the use of CVC are administration of PN, young age and extended use (long indwelling time).
CVC related complications in children on long-term PN contribute significantly to patient morbidity, mortality, and health care costs [6]. Notably, a large proportion of complications are preventable by means of appropriate catheter choice, selection of site and method of insertion, nursing care, handling and hygiene of venous access, all of which are addressed in this chapter.
In the following discussion it is necessary to differentiate between peripheral and central venous access, and between non-tunneled CVC (i.e. inserted via a peripheral vein - PICC) and tunneled CVC inserted subcutaneously.