Incidence of vein thrombosis in peripheral intravenous nutrition: effect of fat emulsions

The relative risk of thrombophlebitis induced by either Long-chain Triglyce rides (LCTs) or Medium-chain Triglycerides (MCTs) during peripheral i.v. nu trition (PIN) was evaluated. A total of 76 patients were randomly assigned into group A (n = 40) and group B (n = 36). The nutritional requirements in both groups were covered by a standardized regime of osmolality 1130 mOsm and pH 5.2, which provided 14 kg/day(-1) nitrogen, 600 kcal/day(-1) of carb ohydrates and 1000 kcal/day(-1) of lipids. Group A received the lipids as p ure LCTs while group B received a mixture of LCTs/MCTs at a ratio 1:1. The infused nutritional volume was 2000 ml and was delivered via a suitable vei n in a proximal forearm, using a fine bore polyurethane 22G catheter. The t wo standardized regimes were evaluated over a 10 day period regarding the i ncidence of thrombophlebitis. The cumulative risk of thrombophlebitis was d ocumented to be significantly lower in group A compared to group B (17.5% v ersus 44.4%, P < 0.05). LCTs appear to prolong peripheral vein feeding by l essening the reaction of venous endothelium to the irritating nutritional i nfusate.