INFLUENCE OF FINE BORE CATHETER LENGTH ON INFUSION THROMBOPHLEBITIS IN PERIPHERAL INTRAVENOUS NUTRITION - A RANDOMIZED CONTROLLED TRIAL

Previous studies indicated that the risk of thrombophlebitis associate d with continuous infusion of intravenous nutrition (IVN) via peripher al veins was reduced when fine-bore catheters, inserted to 15 cm, were used in place of standard intravenous cannulas. An explanation has no t been identified, but may be owing to the greater length of the cathe ters. A randomised controlled study was performed in which a standard nutritional solution was infused via 22 G polyurethane catheters inser ted to a length of either 5 cm or 15 cm. Catheters were reviewed twice each day and removed when complications occurred, or when IVN was no longer required. There was no significant difference in median time to thrombophlebitis or extravasation, or in daily risk of thrombophlebit is, between insertion lengths. Survival proportions were similar for e ach length at all times. Catheters inserted into cephalic veins were m ore prone to thrombophlebitis or extravasation (nine episodes, 14 cath eters) than catheters inserted into basilic veins (five episodes, 24 c atheters, P = 0.009). The survival proportion was at all times greater when catheter tips lay in basilic veins. Thus, the risk of thrombophl ebitis or extravasation was not influenced by the length of catheter w ithin the vein. However, the vein in which the catheter tip lay appear ed to influence the development of morbidity.