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. 1981 Mar;193(3):264–270. doi: 10.1097/00000658-198103000-00002

Central venous catheterization for parenteral nutrition.

F T Padberg Jr, J Ruggiero, G L Blackburn, B R Bistrian
PMCID: PMC1345059  PMID: 6782956

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. One hundred and seventy-five catheters placed in 104 patients were reviewed over an 18 month period. Positive cultures were reported on 11 cannulae for a 6.4% incidence of colonization; five catheters (2.8%) were considered septic. Pleural or mediastinal complications of subclavian or internal jugular venipuncture occurred in eight patients (4.8%). Misdirection of the catheter tip occurred in 11.5% of insertions. Five patients (4.8%) had clinically apparent thrombosis in the superior vena cava, innominate and/or subclavian veins during hospitalization; four 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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Benotti P. N., Bothe A., Jr, Miller J. D., Blackburn G. L. Safe cannulation of the internal jugular vein for long term hyperalimentation. Surg Gynecol Obstet. 1977 Apr;144(4):574–576. [PubMed] [Google Scholar]
  2. Bernard R. W., Stahl W. M. Subclavian vein catheterizations: a prospective study. I. Non-infectious complications. Ann Surg. 1971 Feb;173(2):184–190. doi: 10.1097/00000658-197102000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Copeland E. M., 3rd, Daly J. M., Dudrick S. J. Nutrition as an adjunct to cancer treatment in the adult. Cancer Res. 1977 Jul;37(7 Pt 2):2451–2456. [PubMed] [Google Scholar]
  4. Curry C. R., Quie P. G. Fungal septicemia in patients receiving parenteral hyperalimentation. N Engl J Med. 1971 Nov;285(22):1221–1225. doi: 10.1056/NEJM197111252852203. [DOI] [PubMed] [Google Scholar]
  5. Deitel M., McIntyre J. A. Radiographic confirmation of site of central venous pressure catheters. Can J Surg. 1971 Jan;14(1):42–52. [PubMed] [Google Scholar]
  6. Dudrick S. J., Wilmore D. W., Vars H. M., Rhoads J. E. Long-term total parenteral nutrition with growth, development, and positive nitrogen balance. Surgery. 1968 Jul;64(1):134–142. [PubMed] [Google Scholar]
  7. Harvey K. B., Bothe A., Jr, Blackburn G. L. Nutritional assessment and patient outcome during oncological therapy. Cancer. 1979 May;43(5 Suppl):2065–2069. doi: 10.1002/1097-0142(197905)43:5+<2065::aid-cncr2820430714>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  8. Johnson C. L., Lazarchick J., Lynn H. B. Subclavian venipuncture: preventable complications; report of two cases. Mayo Clin Proc. 1970 Oct;45(10):712–719. [PubMed] [Google Scholar]
  9. Maini B., Blackburn G. L., Bistrian B. R., Flatt J. P., Page J. G., Bothe A., Benotti P., Rienhoff H. Y. Cyclic hyperalimentation: an optimal technique for preservation of visceral protein. J Surg Res. 1976 Jun;20(6):515–525. doi: 10.1016/0022-4804(76)90085-8. [DOI] [PubMed] [Google Scholar]
  10. Maki D. G., Goldman D. A., Rhame F. S. Infection control in intravenous therapy. Ann Intern Med. 1973 Dec;79(6):867–887. doi: 10.7326/0003-4819-79-6-867. [DOI] [PubMed] [Google Scholar]
  11. Maki D. G., Weise C. E., Sarafin H. W. A semiquantitative culture method for identifying intravenous-catheter-related infection. N Engl J Med. 1977 Jun 9;296(23):1305–1309. doi: 10.1056/NEJM197706092962301. [DOI] [PubMed] [Google Scholar]
  12. Ota D. M., Imbembo A. L., Zuidema G. D. Total parenteral nutrition. Surgery. 1978 May;83(5):503–520. [PubMed] [Google Scholar]
  13. Ryan J. A., Jr, Abel R. M., Abbott W. M., Hopkins C. C., Chesney T. M., Colley R., Phillips K., Fischer J. E. Catheter complications in total parenteral nutrition. A prospective study of 200 consecutive patients. N Engl J Med. 1974 Apr 4;290(14):757–761. doi: 10.1056/NEJM197404042901401. [DOI] [PubMed] [Google Scholar]
  14. Tanzawa H., Mori Y., Harumiya N., Miyama H., Hori M. Preparation and evaluation of a new athrombogenic heparinized hydrophilic polymer for use in cardiovascular system. Trans Am Soc Artif Intern Organs. 1973;19:188–194. doi: 10.1097/00002480-197301900-00034. [DOI] [PubMed] [Google Scholar]
  15. Welch G. W., McKeel D. W., Jr, Silverstein P., Walker H. L. The role of catheter composition in the development of thrombophlebitis. Surg Gynecol Obstet. 1974 Mar;138(3):421–424. [PubMed] [Google Scholar]

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