The Experts below are selected from a list of 159 Experts worldwide ranked by ideXlab platform
Walter J. Chwals - One of the best experts on this subject based on the ideXlab platform.
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Vascular access for Home Intravenous Therapy in children.
Journal of Parenteral and Enteral Nutrition, 2006Co-Authors: Walter J. ChwalsAbstract:This review article describes the vascular access devices available for long-term vascular access in children, describes the procedures for implanting them and the sites available for this purpose, discusses the complications associated with catheter placement and how to avoid them, and compares the various catheter systems in terms of their advantages and disadvantages.
Simon Travis - One of the best experts on this subject based on the ideXlab platform.
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management of intestinal failure in inflammatory bowel disease small intestinal transplantation or Home parenteral nutrition
World Journal of Gastroenterology, 2014Co-Authors: Elizabeth Harrison, Philip Allan, Amrutha Ramu, Anil Vaidya, Simon TravisAbstract:Inflammatory bowel disease and Crohn’s disease in particular, is a common cause of intestinal failure. Current therapeutic options include Home parenteral nutrition and intestinal transplantation. For most patients, Home Intravenous Therapy including parenteral nutrition, with a good probability of long-term survival, is the favoured choice. However, in selected patients, with specific features that may shorten survival or complicate Home parenteral nutrition, intestinal transplantation presents a viable alternative. We present survival, complications, quality of life and economic considerations that currently influence individualised decision-making between Home parenteral nutrition and intestinal transplantation.
Elizabeth Harrison - One of the best experts on this subject based on the ideXlab platform.
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management of intestinal failure in inflammatory bowel disease small intestinal transplantation or Home parenteral nutrition
World Journal of Gastroenterology, 2014Co-Authors: Elizabeth Harrison, Philip Allan, Amrutha Ramu, Anil Vaidya, Simon TravisAbstract:Inflammatory bowel disease and Crohn’s disease in particular, is a common cause of intestinal failure. Current therapeutic options include Home parenteral nutrition and intestinal transplantation. For most patients, Home Intravenous Therapy including parenteral nutrition, with a good probability of long-term survival, is the favoured choice. However, in selected patients, with specific features that may shorten survival or complicate Home parenteral nutrition, intestinal transplantation presents a viable alternative. We present survival, complications, quality of life and economic considerations that currently influence individualised decision-making between Home parenteral nutrition and intestinal transplantation.
Joseph G. Mccormack - One of the best experts on this subject based on the ideXlab platform.
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Home Intravenous Therapy in cystic fibrosis: a prospective randomized trial examining clinical, quality of life and cost aspects
The European respiratory journal, 1997Co-Authors: J. M. Wolter, Simon D. Bowler, Pj Nolan, Joseph G. MccormackAbstract:In this study, we set out to determine if Home Intravenous (i.v.) antibiotic Therapy in adult patients with cystic fibrosis (CF) is a feasible, effective and less costly alternative to hospitalization, and to assess the impact of Home Therapy on quality of life. The study was a prospective, randomized, two-factor mixed design involving adults presenting with respiratory exacerbations of CF. Patients were randomized such that they were discharged Home after 2-4 days, or remained in hospital. Seventeen patients had 31 admissions (13 Home and 18 hospital). Following 10 days of Therapy, there were no significant differences between Home or hospital arms with respect to body weight, 12 minute walking distance, sputum weight, pulse oximetry, or improvement in lung function (forced expiratory volume in one second (FEV1), or forced vital capacity (FVC)). Patients who remained in hospital were less fatigued and noted a greater degree of mastery. Patients discharged early noted less disruption to their family life, personal life and sleeping pattern. The total cost for the Home Therapy arm was approximately half that of the hospital Therapy arm. Home Intravenous antibiotic Therapy in patients with cystic fibrosis was a feasible, cost-effective alternative to receiving Therapy in hospital. Although there was no clinical compromise associated with Home Therapy, there were advantages and disadvantages in terms of quality of life.
Mary L. Shafer - One of the best experts on this subject based on the ideXlab platform.
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Infectious complications among patients receiving Home Intravenous Therapy with peripheral, central, or peripherally placed central venous catheters
The American Journal of Medicine, 1991Co-Authors: Donald R. Graham, Marlene M. Keldermans, Linda Wilson Klemm, Nancy J. Semenza, Mary L. ShaferAbstract:Rates of bacteremia among hospitalized patients with central venous catheters range up to 21%. Few data exist for Home Intravenous Therapy (IVT). We studied 300 patients from two hospital-based Home IVT services in 29 months. Diagnoses included 92 cases of osteomyelitis, 33 of pneumonia, 35 of malnutrition, 26 of chronic pain, and 114 of other diseases. Peripheral IVT was given to 97 patients. Mean age was 39.4 years (range, 0.3-98). Hickman, Infuse-A-Port, Broviac, Arrow triple lumen, Hohn, and peripherally inserted central catheters (PICC) were used for a mean of 44 days. Six bacteremias (one death) (2%, 4.6/10,000 catheter days), two subclavian thromboses, 13 catheter site infections, and one additional death occurred. PICC experience included 76 patients, mean age 46 years (range, 4-76), primarily with infections, chronic pain, or dehydration. Mean duration of Therapy was 24 days (0-67) and was completed in 51 patients; others completed Therapy with standard peripheral catheters a mean of 6 days later. Complications included 17 obstructions by clot, 11 cases of phlebitis, six catheter fractures, five punctures, two accidental removals, and one infiltration. Liquid silicone repaired holes; urokinase opened clots. Successful completion of Therapy was more common in the second year, 88% versus 57%. Despite more complications, patients, Home IVT nurses, and physicians preferred PICCs. We conclude that Home IVT is safe via many means of access, with fewer infections than with hospital care. Such infections may be termed "nosohusial."