![]() With regard to swimming: “Swimming introduces an incompletely defined but potentially severe risk to those requiring chronic central venous access. All centers following children with IF should, at a minimum, track the number of outpatient CLABSI per 1000 catheter days.Recommendations for central venous access program management: Children who have lost multiple sites of central venous access should be considered for referral to an intestinal transplant center for evaluation and managementĦ.Children with IF who have persistence of at least one chronic thrombus should be maintained on prophylactic anticoagulation with low molecular weight heparin.Children with IF and a newly identified CRT should be treated with low molecular weight heparin for at least 6 weeks with guidance from a hematologist.In children with IF, CVC should be repaired whenever possible to preserve central venous access.Recommendations pertaining to central line mechanical complications: Prophylactic lock therapy with ethanol or other nonantibiotic locks should be strongly considered in all children with IF who have had at least one central line-associated bloodstream infection or are at high risk for infection.ĥ.If clinically stable, discuss with the patient’s IRP before line removal for CLABSI.All children with IF and CVC who develop a fever (≥38.0☌) should be admitted to the hospital and assessed for bacteremia with central and peripheral blood cultures while receiving broad-spectrum empiric antibiotics through the CVC for at least 48 h, awaiting culture results regardless of other infectious sources.Recommendations regarding central line-associated bloodstream infections: All travel plans should be discussed with the intestinal rehabilitation team well in advance of travel to facilitate discussion of a plan of care in case of emergency.Ĥ.Discuss with families the risks of swimming and sports participation with strategies to protect the dressing and central line.All children with IF should be provided with an emergency letter that details the specific needs of the individual child in case of an emergency.Recommendations regarding general considerations-sports, travel, and emergencies: ![]() MR, CT, or traditional venography should be reserved for when further delineation of access is required.ģ. Routine surveillance of central venous access should be performed by US.CHG impregnated supplies (disk, sponge, or dressing) should be considered for central line dressing in pediatric IF patients.Caregivers should receive directed education regarding CVC care before initial discharge, with subsequent reinforcement education as needed. ![]()
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