Central Venous Catheterization for Parenteral Nutrition

Abstract

To define the risks associated with central venous catheterization for total parenteral nutrition (TPN), 3291 patient days of this therapy delivered by an established nutrition support team were evaluated. Catheters (175) placed in 104 patients were reviewed over 18 mo. Positive cultures were reported on 11 cannulae for a 6.4% incidence of colonization; 5 catheters (2.8%) were considered septic. Pleural or mediastinal complications of subclavian or internal jugular venipuncture occurred in 8 patients (4.8%). Misdirection of the catheter tip occurred in 11.5% of insertions. Five patients (4.8%) had clinically evident thrombosis in the superior vena cava, innominate and/or subclavian veins during hospitalization; 4 others had evidence of thrombosis at autopsy examination, giving an incidence of 8.7% in the entire series. No death directly resulted from the use of this therapy. Compliance with a rigid protocol by an experienced team can allow safe and effective use of central venous catheters and parenteral nutrition therapy.