DO HEPARIN, HYDROCORTISONE, AND GLYCERYL TRINITRATE INFLUENCE THROMBOPHLEBITIS DURING FULL INTRAVENOUS NUTRITION VIA A PERIPHERAL VEIN

The aim of this prospective, randomized study was to determine if the addition of heparin and hydrocortisone, and the application of a topic al glyceryl trinitrate patch over the catheter site (triple therapy) w ould result in a reduced incidence of thrombophlebitis during IV nutri tion through a peripheral vein. Forty-six patients were randomized to receive either standard IV nutrition (IVN) (1200 mosm/kg) (control gro up, n = 23), or IVN plus triple therapy (study group, n = 23). The pat ient's arm was examined daily, and the catheter was removed if signs o f thrombophlebitis were evident. The two groups were well matched in t erms of age and gender, as well as indication for feeding and total da ys of IVN supplied. The catheters in the study group survived longer ( p <.0001), and resulted in a lower incidence of thrombophlebitis (p <. 05). The time of onset of thrombophlebitis was delayed in the study gr oup (p <.0001). It is recommended that heparin, hydrocortisone, and a glyceryl trinitrate patch should be administered to all patients recei ving IV nutrition via a fine-bore peripheral catheter.