Evde Parenteral Nütrisyon Hastalarında Kateter Seçimi ve Kateter Enfeksiyonu Tanısında Öne Çıkan Tanımlar

Yıl 2024, Cilt: 9 Sayı: 3, 263 - 271, 16.09.2024

Ali Tamer , Tunahan Zengin , Oğuz Karabay

https://doi.org/10.26453/otjhs.1470669

Öz

Uzun süreli parenteral beslenmeye ihtiyaç duyan hasta sayısının artması, evde parenteral beslenmeyi zorunlu hale getirmiştir. Uzun süreli santral venöz kateter kullanımı ve parenteral beslenme kendi komplikasyonlarına yol açmıştır. Bunlar arasında kateterle ilişkili kan dolaşımı enfeksiyonları (KİKDE), özellikle sepsis, septik şok ve metastatik enfeksiyonlar gibi yaşamı tehdit eden komplikasyonlarla ilişkilidir. Bu derlemenin ana odağı, kan kültürünün ve sonuçlarının tanımlanması ve yorumlanması, kafa karıştırıcı değişkenler ve rutin uygulamadaki yaygın eksiklikler, KİKDE'yi önlemeye yönelik tanımlar, tanı yöntemleri, önemli klinik ve laboratuvar bulguları ve kateter kurtarma stratejileridir. Farklı santral venöz erişim yöntemlerinin türlerini, göreceli avantaj ve dezavantajları ve mevcut kılavuzların kullandığı tanı kriterleri kıyaslanacaktır. KİKDE ciddi bir komplikasyon olmayı sürdürmektedir ve mevcut literatür ışığında zamanında ivedi müdahalenin ne zaman gerekli olacağını tartışmayı amaçlıyoruz.

Anahtar Kelimeler

Evde parenteral nütrisyon, kateter ilişkili enfeksiyon, sepsis

Catheter Selection in Home Parenteral Nutrition Patients and Noteworthy Definitions in The Diagnosis of Catheter Infections

Öz

The rising number of patients in need of long-term parenteral nutrition has necessitated home parenteral nutrition. Extended usage of central venous catheters and parenteral nutrition has given rise to its own complications. Among them, catheter-related bloodstream infections (CRBSI) are linked to life-threatening complications, especially sepsis, septic shock, and metastatic infections. The principal objective of this review is to define diagnostic methods, notable clinical and laboratory findings, and catheter salvage strategies towards preventing CRBSI, which include defining and interpreting blood culture and its results, its confounding variables and common shortcomings in routine practice. We will discuss the types and relative advantages and disadvantages of differing methods of central venous access and compare the common diagnostic definitions used by existing guidelines. CRBSI remains a serious complication, and we aim to debate when timely intervention will be necessary in light of the existing literature.

Anahtar Kelimeler

Catheter-related infections, parenteral nutrition, home; sepsis

Kaynakça

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