Newsletter

[ Vol. 12 No. 2 ] (May - August 2011 )
A 15-Year experience with peripheral infusion as the route of choice for total parenteral nutrition delivery

V Alivizatos, M Manousi, A Zygomalas, E Karampali
Department of Surgery, Nutrition Unit, “St Andrew” General Hospital, Patra, Greece

Peripheral Parenteral Nutrition (PPN) is an attractive alternative to centrally delivered TPN because of obviates the need for central venous cannulation and its attendant complications. The aim of this study was to present our 15-year experience with peripheral infusion as the route of choice for TPN delivery.

METHOD
From 1/1/1994 to 31/12/2008, all adult patients with suitable peripheral veins for whom had been judged that intravenous feeding would be needed for less than 14 days, were considered eligible for PPN administration. Fine-bore (22-G) peripheral vein catheters and a feeding regimen with an osmolality < 900 mosmol/L (glucose/lipid ratio: 50/50) were used. Small dose of heparin and hydrocortisone were routinely added to each infusate.

RESULTS
Out of 648 patients who received TPN during the study period, 332 (51.2%) were fed exclusively by PPN for a median of 9.1 days and received a total of 3021 days if TPN. 141 patients developed 282 episodes of peripheral vein thrombophlebitis (PVT); the cumulative daily risk of PVT was 0.09 episodes per day (282 episodes in 3021 days of PPN). In 26 patients (7.8%) for whom either a longer period of TPN than originally assessed was indicated or because of unsuitable peripheral veins, conversion to central venous TPN had to be subsequently undertaken.

CONCLUSION
Our results suggest that, for the majority of hospitalized patients who require TPN, PPN represents a suitable alternative of intravenous nutrition without compromising the feeding regimens and with minor morbidity.

From
PENSA 2009
“Energizing Nutrition Support Practice for Life”
June 5-7 2009, Shangri-La Hotel, Kuala Lumpur, Malaysia 
Page: 66