We present a descriptive study of 229 consecutive inpatients requiring intravenous nutrition. These patients received either complete peripheral intravenous nutrition via a fine-bore
silicone catheter (n = 80) or short
Teflon catheter (n = 15) or received conventional central intravenous nutrition (n = 134). Nutrient delivery was similar for both systems, providing 0.2-0.4 g N.kg-1 x day-1 and 0.13-0.15 mJ.kg-1 x day-1 from preparations containing 4.3 MJ/L total energy (65-75%
lipid: 25-35%
glucose for peripheral support and 100%
glucose for central delivery) with 6 g N/L. We compared the incidence of
catheter complication and the probability of
catheter function over time for the peripheral and conventional central systems. Venous access complications were seen only with central venous catheterization (10.4%). Chemical
phlebitis occurred in 17% of fine-bore
catheters and 91.4% of
Teflon catheters. The infective
phlebitis rate of fine-bore
silicone catheters was 1.02% and daily risk of
phlebitis 0.016%, with no instance of device-related
bacteremia or
sepsis. Central-line microbial contamination (21.7%) and
catheter-related
sepsis (3%) were significantly greater (p < 0.0005, chi 2 goodness-of-fit test) than with fine-bore
silicone and
Teflon catheters. The probability of complication-free function against time was similar (0.75 < p < 0.90, log-rank test) in fine-bore
silicone catheters and
central venous catheters. We conclude that fine-bore
silicone catheters provide long-term
phlebitis-free delivery of complete peripheral intravenous nutrition.