VENOUS ACCESS DEVICE RELATED COMPLICATIONS IN ONCOLOGIC PATIENTS ENROLLED ON HOME PARENTERAL NUTRITION

Oncologic patients with important anorexia or alterated digestive tract function, for obstruction or malabsorption, may benefit by Home Parenteral Nutrition. Aim: to evaluate the incidence of venous access related complications in cancer patients undergoing HPN. We included 195 patients enrolled on HPNon the basis of ESPEN guidelines, in 2015- 2016. Incidence of complications were expressed as events per 1000 HPN days, calculated from the HPN start date until the discontinuation of home infusions or the removal of the VAD or the death of the patient. The VADs used were peripherally inserted central catheters (PICCs), subcutaneous implanted port, tunneled central catheters (TCCs) or non tunneled central catheters (NTCCs). 111 males, 84 females; median age 65 years(27-94). Median HPN duration was 106 days. A total of 208 VADs were studied: 67% PICCs, 21% ports, 9% TCCs and 3% NTCCs. Both thrombosis and tip migrations occurred only in PICCs, while infections happened in PICCs, ports and TCCs. The overall incidence of VAD related complications per 1000 HPN days was 0,73(0,27 in TCCs, 0,70 in PICCs, 1,25 in ports and null in NTCCs). HPN results to be a supportive therapy with low rate of VADs related complications. Infections are the most frequent complication and may occur in all kind of devices. Cotogni P. Catheter-related complications in cancer patients on home parenteral nutrition: a prospective study of over 51,000 catheter days. JPEN J Parenter Enteral Nutr. 2013;37(3):375-83 Vashi PG. A longitudinal study investigating quality of life and nutritional outcomes in advanced cancer patients receiving home parenteral nutrition.BMC Cancer.2014;14:593