From the Guidelines
Yes, a permcath can be used for parenteral nutrition, as it is specifically designed for long-term central venous access and is suitable for administering total parenteral nutrition (TPN) when patients require nutritional support for extended periods. Permcaths are typically placed in large central veins such as the internal jugular, subclavian, or femoral veins, with the catheter tunneled under the skin to reduce infection risk 1. When using a permcath for parenteral nutrition, strict aseptic technique must be maintained during all connections and dressing changes to prevent catheter-related bloodstream infections. The catheter should be flushed regularly with heparin or saline according to institutional protocols to maintain patency.
Permcaths are preferred for long-term parenteral nutrition over temporary central lines because they have lower infection rates due to their tunneled design and cuff that creates a barrier against bacterial migration 1. However, they still carry risks including infection, thrombosis, and mechanical complications, so regular assessment of the insertion site and catheter function is essential. The decision to use a permcath should be made after considering the anticipated duration of parenteral nutrition therapy, the patient's vascular access options, and their overall clinical condition.
Some key considerations for using permcaths for parenteral nutrition include:
- The type of catheter used, with tunneled silicone rubber catheters being the most commonly used method for long-term parenteral nutrition 1
- The size of the catheter, with smaller sizes recommended to minimize complications 1
- The patient's quality of life, including their age, daily activities, and personal preferences regarding the type of catheter 1
- The potential risks and benefits of using a permcath, including the risk of infection, thrombosis, and mechanical complications 1.
From the Research
Permcath for Parental Nutrition
- Permcath, a type of central venous catheter, can be used for parental nutrition, but it is associated with risks of catheter-related complications, including infections and thrombosis 2, 3, 4, 5, 6.
- The use of permcath for parental nutrition increases the risk of central line-associated bloodstream infections (CLABSIs) and catheter-related bloodstream infections (CRBSIs) 2, 3, 5.
- Studies have shown that the rates of catheter complications, including CLABSIs and CRBSIs, are higher among patients receiving parental nutrition compared to those who do not receive parental nutrition 2, 3, 5.
- The use of antimicrobial lock therapy (ALT) and anticoagulation therapy may help reduce the risk of catheter-related complications, but more research is needed to determine the effectiveness of these strategies 2, 4.
- Patient factors, such as age, gender, and insurance type, may also influence the risk of catheter-related complications in patients receiving parental nutrition via permcath 5.