Which of the following are approved VADs for HPN administration?

• A. Tunneled central venous catheters
• B. Implanted ports
• C. Peripherally inserted central catheters
• D. All of the above

Answer: (D)

Delivering home parenteral nutrition requires reliable central venous access that can safely carry hypertonic nutrition solutions into the central circulation. Tunneled central venous catheters are designed for long-term use and provide durable access with a subcutaneous tunnel and cuff to reduce infection. Implanted ports offer long-term, discreet access with the catheter ending in a central vein and accessed through a skin port when needed. Peripherally inserted central catheters are placed from a peripheral vein and extend to a central vein, suitable for PN in many patients depending on duration and individual risks. The choice among these depends on therapy length, infection risk, patient lifestyle, and care resources, but all three types can be used to administer home parenteral nutrition, making all of the above appropriate VADs for HPN administration.