Retaining venous access and eliminating radiation exposure during Hickman-Broviac catheter replacement for difficult-line insertion patients with intestinal failure

Hickman-Broviac catheters are commonly used to access central veins for the purposes of intravenous nutrition delivery for intestinal failure (IF) patients. While these catheters are good options for accessing central veins, they often have to be replaced if catheter-related infection or occlusion o...

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Main Authors: Justin T Chu, Chee-Chee Koh, Yun Chen
Format: Article
Language:English
Published: Wolters Kluwer Health/LWW 2021-01-01
Series:Formosan Journal of Surgery
Subjects:
Online Access:http://www.e-fjs.org/article.asp?issn=1682-606X;year=2021;volume=54;issue=1;spage=36;epage=38;aulast=Chu
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author Justin T Chu
Chee-Chee Koh
Yun Chen
author_facet Justin T Chu
Chee-Chee Koh
Yun Chen
author_sort Justin T Chu
collection DOAJ
description Hickman-Broviac catheters are commonly used to access central veins for the purposes of intravenous nutrition delivery for intestinal failure (IF) patients. While these catheters are good options for accessing central veins, they often have to be replaced if catheter-related infection or occlusion occurs. Frequent replacement can be hampered by the limited venous access sites in these patients and reduce the access site's lifespan. In this technical note, we describe a technique to periodically replace Hickman-Broviac catheters without having to create a new venous access site. Without requiring radiation exposure by standardized guidewire insertion, we safely utilize the fibrotic pseudocapsule that forms around the old catheter to guide the new catheter to the central veins while creating a different exit site to prevent infection. The procedure should be performed periodically – we advocate annually – before catheter-related infection occurs. In this way, we hope to be able to provide a solution for IF patients who require life-long catheter usage but have limited venous access, while also reducing the risk of related injuries such as pneumothorax, arterial injury, or radiation exposure.
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spelling doaj.art-07baf76b32d94e099aa71c4a198a0fe92023-09-03T08:31:37ZengWolters Kluwer Health/LWWFormosan Journal of Surgery1682-606X2021-01-01541363810.4103/fjs.fjs_90_20Retaining venous access and eliminating radiation exposure during Hickman-Broviac catheter replacement for difficult-line insertion patients with intestinal failureJustin T ChuChee-Chee KohYun ChenHickman-Broviac catheters are commonly used to access central veins for the purposes of intravenous nutrition delivery for intestinal failure (IF) patients. While these catheters are good options for accessing central veins, they often have to be replaced if catheter-related infection or occlusion occurs. Frequent replacement can be hampered by the limited venous access sites in these patients and reduce the access site's lifespan. In this technical note, we describe a technique to periodically replace Hickman-Broviac catheters without having to create a new venous access site. Without requiring radiation exposure by standardized guidewire insertion, we safely utilize the fibrotic pseudocapsule that forms around the old catheter to guide the new catheter to the central veins while creating a different exit site to prevent infection. The procedure should be performed periodically – we advocate annually – before catheter-related infection occurs. In this way, we hope to be able to provide a solution for IF patients who require life-long catheter usage but have limited venous access, while also reducing the risk of related injuries such as pneumothorax, arterial injury, or radiation exposure.http://www.e-fjs.org/article.asp?issn=1682-606X;year=2021;volume=54;issue=1;spage=36;epage=38;aulast=Chuhickman-broviac catheterintestinal failureretaining central venous access
spellingShingle Justin T Chu
Chee-Chee Koh
Yun Chen
Retaining venous access and eliminating radiation exposure during Hickman-Broviac catheter replacement for difficult-line insertion patients with intestinal failure
Formosan Journal of Surgery
hickman-broviac catheter
intestinal failure
retaining central venous access
title Retaining venous access and eliminating radiation exposure during Hickman-Broviac catheter replacement for difficult-line insertion patients with intestinal failure
title_full Retaining venous access and eliminating radiation exposure during Hickman-Broviac catheter replacement for difficult-line insertion patients with intestinal failure
title_fullStr Retaining venous access and eliminating radiation exposure during Hickman-Broviac catheter replacement for difficult-line insertion patients with intestinal failure
title_full_unstemmed Retaining venous access and eliminating radiation exposure during Hickman-Broviac catheter replacement for difficult-line insertion patients with intestinal failure
title_short Retaining venous access and eliminating radiation exposure during Hickman-Broviac catheter replacement for difficult-line insertion patients with intestinal failure
title_sort retaining venous access and eliminating radiation exposure during hickman broviac catheter replacement for difficult line insertion patients with intestinal failure
topic hickman-broviac catheter
intestinal failure
retaining central venous access
url http://www.e-fjs.org/article.asp?issn=1682-606X;year=2021;volume=54;issue=1;spage=36;epage=38;aulast=Chu
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AT cheecheekoh retainingvenousaccessandeliminatingradiationexposureduringhickmanbroviaccatheterreplacementfordifficultlineinsertionpatientswithintestinalfailure
AT yunchen retainingvenousaccessandeliminatingradiationexposureduringhickmanbroviaccatheterreplacementfordifficultlineinsertionpatientswithintestinalfailure