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Komplikationen bei total parenteraler Ernährung

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Praxishandbuch klinische Ernährung und Infusionstherapie

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Zusammenfassung

Die Komplikationshäufigkeit der total parenteralen Ernährung (TPE) hat seit ihren Anfängen in den 1960er Jahren durch verbesserte Kenntnis von Nährstoffbedarf und möglichen Stoffwechselkomplikationen einerseits sowie durch weitgehende Standardisierung der technischen Durchführung und Überwachung andererseits stark abgenommen. Dennoch zählen Katheterprobleme und Stoffwechselstörungen weiterhin zu den Hauptkomplikationen einer parenteralen Ernährung. Insbesondere bei langfristiger parenteraler Ernährung rücken Stoffwechselentgleisungen meist in Verbindung mit Mangelzuständen mit zunehmender Dauer der künstlichen Ernährung in den Mittelpunkt. In einer 1989 in Europa von Messing et al. [58] durchgeführten Multicenteranalyse fanden sich bei 194 Patienten, die länger als 12 Monate parenteral ernährt wurden, in 30% der Fälle metabolische Komplikationen, 20% zeigten Knochenveränderungen, 29% Leberfunktionsstörungen und 12% Gallensteine.

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Literatur

  1. Abi-Said D, Raad I, Umphrey J et al. (1999) Infusion therapy team and dressing changes of central venous catheters. Infect Control Hosp Epidemiol 20: 101–105

    Article  PubMed  CAS  Google Scholar 

  2. Angelico M, Delia GP (2000) Review article: Hepatobiliary complications associated with total parenteral nutrition. Aliment Pharmacol Ther 14: 54–57

    Article  PubMed  Google Scholar 

  3. Atkinson JB, Bagnall HA, Gomberts E (1990) Investigational use of tissue plasminogen activator (t-PA) for occluded central venous catheters. JPEN J Parenter Enteral Nutr 14: 310–311

    Article  PubMed  CAS  Google Scholar 

  4. Attar A, Messing B (2001) Evidence-based prevention of catheter infection during parenteral nutrition. Curr Opin Clin Nutr Metab Care 4: 211–218

    Article  PubMed  CAS  Google Scholar 

  5. Bach A, Eberhardt H, Frick A et al. (1999) Efficacy of silver-coating central venous catheters in reducing bacterial colonization. Crit Care Med 27: 515–521

    Article  PubMed  CAS  Google Scholar 

  6. Barclay GR, Allen K, Pennington CR (1990) Tissue plasminogen activator in the treatment of superior vena caval thrombosis associated with parenteral nutrition. Postgrad Med J 66: 398–400

    Article  PubMed  CAS  Google Scholar 

  7. Benoit JL, Carandang G, Sitrin M, Arnow PM (1995) Intraluminal antibiotic treatment of central venous catheter infections in patients receiving parenteral nutrition at home. Clin Infect Dis 21: 1286–1288

    Article  PubMed  CAS  Google Scholar 

  8. Bern MM, Lokich JJ, Wallach SR et al. (1990) Very low doses of Warfarin can prevent thrombosis in central venous catheters. Ann Intern Med 112: 423–428

    PubMed  CAS  Google Scholar 

  9. Bijma R, Girbes AR, Kleijer DJ, Zwaveling JH (1999) Preventing central venous catheter-related infection in a surgical intensive-care unit. Infect Control Hosp Epidemiol 20: 618–620

    Article  PubMed  CAS  Google Scholar 

  10. Blot F, Brun-Buisson C (1999) Current approaches to the diagnosis and prevention of catheter-related infections. Curr Opin Crit Care 5: 341–349

    Article  Google Scholar 

  11. Boncompain-Gerard M, Robert D, Fouque D, Hadj-Aissa A (2000) Renal function and urinary excretion of electrolytes in patients receiving cyclic parenteral nutrition. JPEN J Parenter Enteral Nutr 24: 234–239

    Article  PubMed  CAS  Google Scholar 

  12. Brooks MJ, Melnik G (1995) The refeeding syndrome: An approach to understanding its complications and preventing its occurrence. Pharmacotherapy 15: 713–726

    PubMed  CAS  Google Scholar 

  13. Buchman AL (2001) Complications of long-term home total parenteral nutrition: their identification, prevention and treatment. Dig Dis Sei 46: 1–18

    Article  CAS  Google Scholar 

  14. Buchman AL, Moukarzel A (2000) Metabolic bone disease associated with total parenteral nutrition. Clin Nutr 19: 217–231

    Article  PubMed  CAS  Google Scholar 

  15. Buchman AL, Moukarzel A, Goodson B et al. (1994) Catheter-related infections associated with home parenteral nutrition and predictive factors for the need for catheter removal in their treatment. JPEN J Parenter Enteral Nutr 18: 297–302

    Article  PubMed  CAS  Google Scholar 

  16. Carratala J, Niubo J, Fernandez-Sevilla A et al. (1999) Randomized, double-blind trial of an antibiotic-lock technique for prevention of gram-positive central venous catheter-related infection in neutropenic patients with cancer. Antimicrob Agents Chemother 43: 2200–2204

    PubMed  CAS  Google Scholar 

  17. Cavicchi M, Beau P, Crenn P et al. (2000) Prevalence of liver disease and contributing factors in patients receiving home parenteral nutrition for permanent intestinal failure. Ann Intern Med 132: 525–532

    PubMed  CAS  Google Scholar 

  18. Clarke DE, Raffin TA (1990) Infectious complications of indwelling long-term central venous catheters. Chest 97: 966–972

    Article  PubMed  CAS  Google Scholar 

  19. Clarke-Christoff N, Watters N, Sparks VA et al. (1992) Use of triple-lumen subclavian catheters for administration of total parenteral nutrition. JPEN J Parenter Enteral Nutr 16: 403–407

    Article  Google Scholar 

  20. Clayton PT, Whitfield P, Iyer K (1998) The role of phytosterols in the pathogenesis of liver complications of pediatric parenteral nutrition. Nutrition 14: 158–164

    Article  PubMed  CAS  Google Scholar 

  21. Colomb V, Jobert-Giraud A, Lacaille F et al. (2000) Role of lipid emulsions in cholestasis associated with long-term parenteral nutrition in children. JPEN J Parenter Enteral Nutr 24: 345–350

    Article  PubMed  CAS  Google Scholar 

  22. Cottee S (1995) Heparin lock practice in total parenteral nutrition. Prof Nurse 11: 25–28

    PubMed  CAS  Google Scholar 

  23. Cowl CT, Weinstock JV, Al Jurf A et al. (2000) Complications and cost associated with parenteral nutrition delivered to hospitalized patients through either subclavian or peripherally-associated central catheters. Clin Nutr 19: 237–243

    Article  PubMed  CAS  Google Scholar 

  24. Crook MA, Hally V, Panteli JV (2001) The importance of the refeeding syndrome. Nutrition 17: 632–637

    Article  PubMed  CAS  Google Scholar 

  25. Darouiche RO, Raad II, Heard SO et al. (1999) A comparison of two antimicrobial-impregnated central venous catheters. N Engl J Med 340: 1–8

    Article  PubMed  CAS  Google Scholar 

  26. Denny DF (1993) Placement and management of long-term central venous access catheters and ports. AJR Am J Radiol 161: 385–393

    Google Scholar 

  27. Do AN, Ray BJ, Banerjee SN et al. (1999) Bloodstream infection associated with needleless device use and the importance of infection-control practices in the home health care setting. J Infect Dis 179: 442–448

    Article  PubMed  CAS  Google Scholar 

  28. Duerksen DR, Papineau N, Siemens J, Yaffe C (1999) Peripherally inserted central catheters for parenteral nutrition: a comparison with centrally inserted catheters. JPEN J Parenter Enteral Nutr 23: 85–89

    Article  PubMed  CAS  Google Scholar 

  29. Early TF, Gregory RT, Wheeler JR et al. (1990) Increased infection rate in double-lumen vs. single-lumen Hickman catheters in cancer patients. South Med J 83: 34–36

    Article  PubMed  CAS  Google Scholar 

  30. Elliott TS (1999) Role of antimicrobial central venous catheters for the prevention of associated infections. J Antimicrob Chemoth 43: 441–446

    Article  CAS  Google Scholar 

  31. Epperson EL (1984) Efficacy of 0.9% sodium chloride injection with and without heparin for maintaining indwelling intermittent injection sites. Clin Pharm 3: 626–629

    PubMed  CAS  Google Scholar 

  32. Farkas JC, Liu N, Bleriot JP et al. (1992) Single vs. triple-lumen central catheter-related sepsis: a peospective randomized study in a critically ill population. Am J Med 93: 277–282

    Article  PubMed  CAS  Google Scholar 

  33. Faubion WC, Wesley JR, Khalidi N et al. (1986) Total parenteral nutrition catheter sepsis: Impact of the team approach. JPEN J Parenter Enteral Nutr 10: 642–645

    Article  PubMed  CAS  Google Scholar 

  34. Forbes GM, Forbes A (1997) Micronutrient status in patients receiving home parenteral nutrition. Nutrition 13: 941–944

    Article  PubMed  CAS  Google Scholar 

  35. Gil RT, Kruse JA, Thill-Baharozian MC, Carlson RW (1989) Triple vs. single-lumen central venous catheters: a prospective study in a critically ill population. Arch Int Med 149: 1139–1145

    Article  CAS  Google Scholar 

  36. Goetz AM, Wagener MM, Miller JM, Muder RR (1998) Risk of infection due to central venous catheters: effect of site of placement and catheter type. Infect Control Hosp Epidemiol 19: 842–845

    Article  PubMed  CAS  Google Scholar 

  37. Gray BH, Olin JW, Graor RA et al. (1991) Safety and efficacy of thrombolytic therapy for superior vena cava syndrome. Chest 99: 54–59

    Article  PubMed  CAS  Google Scholar 

  38. Guggenbichler JP, Boswald M, Lugauer S, Krall T (1999) A new technology of microdispersed silver in polyurethane induces antimicrobial activity in central venous catheters. Infection 27: S16–S23

    Article  PubMed  CAS  Google Scholar 

  39. Guglielmi FW et al. (2001) Hepatobiliary complications of long-term home parenteral nutrition. Clin Nutr 20: S51–S55

    Google Scholar 

  40. Haire WD, Atkinson JB, Stephens LC (1994) Urokinase vs. t-PA in thrombosed central venous catheter. Thromb Haemostas 72: 543–547

    CAS  Google Scholar 

  41. Haire WD, Herbst SL (2000) Use of alteplase (t-PA) for the management of thrombotic catheter dysfunction: Guidelines from a consensus conference of the National Association of Vascular Access Networks (NAVAN). Nutr Clin Pract 15: 265–275

    Article  Google Scholar 

  42. Halevy A, Leonov Y, Lewinshon G et al. (1988) Thrombosis of superior vena cava during total parenteral nutrition managed successfully with low dose streptokinase. Intens Care Med 14: 72–73

    Article  CAS  Google Scholar 

  43. Herbst SL, Kaplan LK, McKinnon BT (1988) Vascular access devices: Managing occlusions and related complications in home infusion. Infusion 4: S1–S32

    Google Scholar 

  44. Hofmann AF (1995) Defective biliary secretion during total parenteral nutrition: probable mechanisms and possible solutions. J Pediatr Gastroenterol Nutr 20: 376–390

    Article  PubMed  CAS  Google Scholar 

  45. Howard L, Hassan N (1998) Home parenteral nutrition. 25 years later. Gastroenterol Clin North Am 27: 481–512

    Article  PubMed  CAS  Google Scholar 

  46. Jeejeebhoy KN (2001) Total parenteral nutrition: potion or poison? Am J Clin Nutr 74: 160–163

    PubMed  CAS  Google Scholar 

  47. Johnson BH, Rypins EB (1990) Single lumen vs. double-lumen catheters for total parenteral nutritions randomized prospective trial. Arch Surg 125: 990–999

    Article  PubMed  CAS  Google Scholar 

  48. Johnson CD, Kudsk KA (1999) Nutrition and intestinal mucosal immunity. Clin Nutr 18: 337–344

    Article  PubMed  CAS  Google Scholar 

  49. Jurewitsch B, Lee T, Park I, Jeejeebhoy K (1998) Taurolidine 2% as an antimicrobial lock solution for prevention of recurrent catheter-related bloodstream infections. JPEN J Parenter Enteral Nutr 22: 242–244

    Article  PubMed  CAS  Google Scholar 

  50. Keung Y, Watkins K, Chen S et al. (1994) Comparative study of infectious complications of different types of chronic central venous access devices. Cancer 73: 2832–2837

    Article  PubMed  CAS  Google Scholar 

  51. Lecciones JA, Lee JW, Navarro EE et al. (1992) Vascular catheter-associated fungemia in patients with cancer: Analysis of 155 episodes. Clin Infect Dis 14: 875–883

    Article  PubMed  CAS  Google Scholar 

  52. Ma TY, Yoshinaka R, Banaag A et al. (1998) Total parenteral nutrition via multilumen catheters does not increase the risk of catheter-related sepsis: a randomized, prospective study. Clin Infect Dis 27: 500–503

    Article  PubMed  CAS  Google Scholar 

  53. Main J, Pennington CR (1984) Catheter blockage with lipid during long term parenteral nutrition. Br J Surg 289: 734

    Google Scholar 

  54. Maki DG, Band JD (1981) A comparative study of polyantibiotic and iodophor ointments in prevention of vascular catheter-related infection. Am J Med 70: 738–744

    Google Scholar 

  55. Maloney KW, Hillary CA, Nelson TJ, Gill JC (1999) The use of aliquoted and frozen t-PA in central venous line occlusion. Blood 1: 114-I (Abstract)

    Google Scholar 

  56. Maroulis J, Kalfarentzos F (2000) Complications of parenteral nutrition at the end of the century. Clin Nutr 19: 295–304

    Article  PubMed  CAS  Google Scholar 

  57. McCarthy MC, Shives JK, Robinson RJ, Broadie TK (1987) Prospective evaluation of single and triple-lumen catheters in total parenteral nutrition. JPEN J Parenter Enteral Nutr 11: 259–264

    Article  PubMed  CAS  Google Scholar 

  58. Mermel LA, Farr BM, Sheretz RJ (2001) Guidelines for the management of intravascular catheter-related complications. Clin Infect Dis3 2: 1249–1272

    Article  Google Scholar 

  59. Messing B (1989) Proceedings of the first congress of artificial feeding at home. Rev Prat 39: 2253–2255

    PubMed  CAS  Google Scholar 

  60. Mirro J Jr, Rao BN, Kumar M et al. (1990) A comparison of placement techniques and complications of externalized catheters and implantable port use in children with cancer. J Pediatr Surg 25: 120–124

    Article  PubMed  Google Scholar 

  61. Mueller BU, Skelton J, Callender DP et al. (1992) A prospective randomized trial comparing infectious and noninfectious complications of an externalized catheter vs. a subcutaneously implanted device in cancer patients. J Clin Oncol 12: 1943–1948

    Google Scholar 

  62. Muscedere G, Bennett JD, Lee TY, Mackie l, Vanderburgh L (1998) Complications of radiologically-placed central venous ports and Hickman catheters in patients with AIDS. Can Assoc Radiol 49: 84–89

    CAS  Google Scholar 

  63. Pasquale MD, Campbell JM, Magnanht CM (1992) Groshong vs. Hickman catheters. Surg Gynecol Obstet 174: 408–410

    PubMed  CAS  Google Scholar 

  64. Pearson ML (1996) Giudeline for prevention of intravascular device-related infections. Part I. Intravascular device-related infections: an overview. The Hospital Infection Control Practices Advisory Committee. Am J Infect Control 24: 262–277

    Article  PubMed  CAS  Google Scholar 

  65. Pegues D, Axelrod P, McClarren C et al. (1992) Comparison od infections in Hickman and implanted port catheters in adult solid tumor patients. J Surg Oncol 49: 156–162

    Article  PubMed  CAS  Google Scholar 

  66. Pironi L (2001) Metabolic bone disease in long-term home parenteral nutrition. Clin Nutr 20: S43–S46

    Article  Google Scholar 

  67. Quillici N, Audibert G, Controy MC et al. (1997) Differential quantitative blood cultures in the diagnosis of catheter-related sepsis in intensive care units. Clin Infect Dis 25: 1066–1070

    Article  Google Scholar 

  68. Rannen T, Ladefofed K, Tvede M et al. (1986) Catheter-related septicaemia in patients receiving home parenteral nutrition. Scand J Gastroenterol 21: 455–460

    Article  Google Scholar 

  69. Ross MN, Haase GM, Poole MA et al. (1988) Comparison of totally implanted reservoirs with external catheters as venous access devices in pediatric oncologic patients. Surg Gynecol Obstet 167: 141–144

    PubMed  CAS  Google Scholar 

  70. Salwender HJ, Egerer G, Bach A et al. (2000) Central venous catheter-related complications. J Antimicrob Chemoth; 50: 133–14

    CAS  Google Scholar 

  71. Sando K, Fujii M,Tanaka K et al. (1997) Lock method using sodium hydroxide solution to clear occluded central venous access devices. Clin Nutr 16: 185–188

    Article  PubMed  CAS  Google Scholar 

  72. Sherertz RJ, Ely EW, Westbrook DM et al. (2000) Education of physicians-in-training can decrease the risk for vascular catheter infection. Ann Intern Med 132: 641–648

    PubMed  CAS  Google Scholar 

  73. Sherman R, Flynn NM et al. (1988) Multi-lumen catheter sepsis and an educational programme to combat it. Am J Infect Control 16: 31A–34A

    Article  PubMed  CAS  Google Scholar 

  74. Shulman RJ, Smith EO, Rahman S et al. (1988) Single vs. double-lumen central venous catheters in pediatric oncology patients. Am J Dis Child 142: 839–842

    Google Scholar 

  75. Solomon BA, Solomon J, Shlansky-Goldberg R (2001) Percutaneous placement of an intercostal central venous catheter for chronic hyperalimentation guided by transhepatic venography. JPEN J Parenter Enteral Nutr 25: 42–44

    Article  PubMed  CAS  Google Scholar 

  76. Teitelbaum DH (1997) Parenteral nutrition-associated cholestasis. Curr Opin Pediatr 9: 270–275

    Article  PubMed  CAS  Google Scholar 

  77. Tokars Jl, Cookson ST, McArthur MA et al. (1999) Prospective evaluation of risk factors for bloodstream infection in patients receiving home infusion therapy. Ann Intern Med 131: 340–347

    PubMed  CAS  Google Scholar 

  78. Waitzberg DL, Plooper C, Terr RM (2000) Access routes for nutritional therapy. World J Surg 24: 1468–1476

    Article  PubMed  CAS  Google Scholar 

  79. Warner BW, Haygood MM, Davies SL, Hennies GA (1996) A randomized prospective trial of standard Hickman compared with Groshong central venous catheters in pediatric oncology patients. J Am Coll Surg 183: 140–144

    PubMed  CAS  Google Scholar 

  80. Wickham R, Purl S, Welken D (1992) Long term central venous catheters: issues for care. Semin Oncol 8: 133–147

    Article  CAS  Google Scholar 

  81. Widmer AF (1997) Management of catheter-related bacteremia and fungemia in patients on total parenteral nutrition. Nutrition 13: S18–S25

    Article  Google Scholar 

  82. Yared G, Seidner DL, Steiger E, Hall PM, Nally JW (1999) Tunneled right atrial catheter infection presenting as renal failure. JPEN J Parenter Enteral Nutr 23: 363–365

    Article  PubMed  CAS  Google Scholar 

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  1. J. Stein
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  2. R.-J. Schulz
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  3. B. Leube
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Editors and Affiliations

  1. Medizinische Klinik II, Zentrum der Inneren Medizin Gastroenterologie/Klinische Ernährung, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland

    J. Stein

  2. Chirurgische Klinik mit Poliklinik der LMU München-Großhadern, Marchioninistraße 15, 81377, München, Deutschland

    K.-W. Jauch

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Stein, J., Schulz, RJ., Leube, B. (2003). Komplikationen bei total parenteraler Ernährung. In: Stein, J., Jauch, KW. (eds) Praxishandbuch klinische Ernährung und Infusionstherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55896-2_29

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  • DOI: https://doi.org/10.1007/978-3-642-55896-2_29

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