Randomised comparison of silicone versus Teflon cannulas for peripheral intravenous nutrition.
The use of peripheral intravenous nutrition using standard Teflon cannulas is limited by a high incidence of thrombophlebitis, with resultant frequent line changes and compromised nutritional therapy. Fine-bore silicone catheters may reduce the incidence of thrombophlebitis; we prospectively compared the silicone catheter with a Teflon cannula in a randomised trial. Seventy-nine surgical patients were randomised to receive peripheral nutrition (10 g nitrogen; 1770 kcal; 650 mOsm/l) either via a Teflon cannula (18G, 4.4 cm long) or via a silicone catheter (23G, 15 cm long). Compared with the group randomised to a standard Teflon cannula, patients fed via a silicone catheter had a significant (P < 0.001) improvement in (a) median time to survival of the first catheter (125 h vs 48 h); (b) incidence of catheter reinsertions (13% vs 75%); and (c) incidence of thrombophlebitis (10% vs 48%). Delivery of a moderately hypertonic nutritional solution through a fine-bore silicone catheter is safe, durable and well tolerated, with a low incidence of complications relative to a Teflon cannula. An expanded role for this catheter in nutritional therapy is feasible, which may reduce the requirement for central venous parenteral nutrition.
Department of Surgical Nutrition, St Vincent's Hospital, Dublin.
J V
JV
Reynolds
K
K
Walsh
J
J
Ruigrok
J M
JM
Hyland
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000295:instrumentation*; D011138:Polytetrafluoroethylene; D012826:Silicone Elastomers; D013924:Thrombophlebitis / Q000209:etiology
D012826:Silicone Elastomers; D011138:Polytetrafluoroethylene