游泳或不游泳：留置中心静脉导管的游泳实践调查

　　家庭肠外营养（HPN）患者长期留置中心静脉导管（CVC），会影响患者的生活质量。

　　美国家庭肠外肠内营养支持疗法非营利组织ThriveRx对182例HPN患者的游泳情况进行调查，结果显示55%患者在留置CVC情况下游泳，其中61%使用了CVC防护罩，93%患者未发生游泳后CVC感染。大多数患者对游泳有较强的意愿，因此对长期HPN患者游泳的标准化管理有待制定。

JPEN J Parenter Enteral Nutr. 2016;40(4):136-137.

To Swim or Not to Swim: Survey on Swimming Practices With a Central Venous Catheter.

Carol Cheney; Kristi Griggs; Stacie Brandt; Kelly Sutich; Lloydette Zieman; Deborah Pfister.

ThriveRx, Cincinnati, OH, USA.

Purpose: Quality-of-life issues are an important concern for those who are on long-term home parenteral nutrition (HPN). One issue verbalized by consumers involves swimming while having a central venous catheter (CVC) in place. Requests for guidance on safe procedures for this activity are directed to this provider of long-term nutrition support. As a result of very limited published research and the lack of evidence-based recommendations in this area, a survey was designed to identify attitudes and practices of the HPN consumer surrounding swimming with a CVC.

Methods: To determine if a correlation exists between swimming and the incidence of line infection, an anonymous electronic survey was distributed randomly to the HPN community via social media. The survey consisted of 11 questions pertaining to the practice of swimming with a CVC and specific practices of CVC care. The survey also queried regarding practice awareness by the consumer's medical team.

Results: Of the 182 consumers with a CVC who were surveyed, 158 (87%) reported that swimming was important to them, and 101 (55%) reported actually swimming with a CVC. Of the CVC swimmers, 71 reported swimming in a pool; 24 reported swimming in the ocean; 5 reported swimming in a lake; and 11 reported swimming in all 3 media. As for line care practice, 62 (61%) of the CVC swimmers wore CVC-protective covering during swimming, with 16 of the 62 wearing wetsuits. Thirty-six (36%) reported not wearing any protective covering, and 2 did not respond to the question. Sixty-one (60%) CVC swimmers reported changing their dressing immediately after swimming; 36 (36%) reported changing the dressing as needed; and 2 did not respond to the question. Ninety-four (93%) CVC swimmers reported having 0 CVC infections after swimming; 6 (6%) reported 1 CVC infection; and 1 (1%) reported 2 CVC infections. Of those reporting infections, all but 1 reported wearing a CVC-protective covering, and 6 reported changing their CVC dressing immediately after swimming. Of the 101 CVC swimmers, 63 (62%) reported that their medical team knew that they swam, with 43 (68%) of these informed teams allowing swimming and 20 (32%) of these teams prohibiting swimming. Thirty-eight (38%) CVC swimmers reported that their team was not aware of the activity.

Conclusions: Consumer practice of swimming with a CVC varies by swimming location, care of the CVC during and after the activity, and notification of the medical team regarding swimming practice. The ability to swim was reported as being an important contribution to quality of life in the HPN consumer. Further research to explore documented CVC infections relative to swimming practice will assist in development of standardized practice.

Financial support: BioRx.