Selbstbestimmung durch Automatisierung und Digitalisierung in der Heimparenteralen Ernährung

Prof. Dr.-Ing. Diana Völz

Frankfurt University of Applied Sciences

Development of an Effective and Reproducible Flushing Protocol for Port Catheters in Home Parenteral Nutrition 

To improve safety in home parenteral nutrition (HPN) and support future patient self-management, a digital assistance system is being developed that combines process guidance with automated support functions. The assistance system is intended to provide digital step-by-step process guidance, reduce process-related risks, and facilitate the implementation of an effective flushing pattern. 

An experimental study was carried out to derive reproducible design parameters for effective port catheter flushing as a basis for supporting care professionals and for future automation. Manual and automated flushing procedures were experimentally investigated on a bespoke ex vivo test bench. A design-of-experiments approach was used to compare the effects of volume flow, flushing and pause times, pulse number, and flushing volume. To ensure reproducibility, a standardized preparation and evaluation procedure was established. Flushing effectiveness was quantified using gravimetric difference measurements. 

The qualitative evaluation of flushing patterns in manual irrigation by nursing staff using a 10 ml syringe filled with NaCl in terms of irrigation effectiveness showed that different patterns can be effective. This result reflects the heterogeneity observed in practice. Successful flushing patterns were characterized by rapid pressure build-up and pulsatile flow behavior without reaching the theoretical threshold for turbulent flow, suggesting that the observed effect was caused by intermittent interruptions of volume flow. 

In automated follow-up tests, a defined flush pattern was created by controlling a peristaltic pump via a stepper motor. Improved flushing performance was primarily achieved with larger flushing volumes and continuous flushing, yielding flushing effectiveness of 94–100%. These findings indicate that flushing efficacy depends on defined hydrodynamic conditions rather than on a single manual pattern. The results provide initial design parameters for the development of automated flushing functions and their integration into digital assistance systems for HPN. 

49.000 Euro (2024)