Document Detail


The effect of heparin in peripheral intravenous nutrition via a fine-bore midline: a randomised double-blind controlled trial.
MedLine Citation:
PMID:  16310895     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: Peripheral intravenous nutrition (PIVN) delivered via a finebore midline offers a viable alternative to central venous feeding. The major complication is the onset of peripheral vein thrombophlebitis (PVT). Feed additives such as heparin and hydrocortisone have been advocated in its prevention. Concern over the safety of heparin has prevented its widespread use; this study examines its true benefit. METHODS: A randomised, double-blind trial comparing the addition of either, Heparin 1500 units or hydrocortisone 15 mg or a combination of the two to full intravenous nutrition (IVN) (2500 ml, 13 g of nitrogen, 1190 m0sm/k) was performed. All feeds were delivered via a finebore midline inserted via an antecubital fossa vein. Feeding was terminated in the event of complication or cessation of intended nutritional support. RESULTS: One hundred and twenty-three episodes of feeding occurred in 110 patients. The incidence of peripheral vein thrombosis was similar in each group (Heparin 30% (12/41), hydrocortisone 33% (14/42), combination 31% (13/41) chi(2) test P>0.05). There was a significant difference in total catheter survival with the addition of heparin to the feeds, either alone (11 days (SEM 1.79) or in combination with hydrocortisone (11.7 days (SEM 1.39) compared with those receiving only hydrocortisone (6.9 days (SEM 0.73) P=0.002 and 0.030, respectively)). CONCLUSION: When intravenous feeds are delivered in to a peripheral vein via a fine-bore midline, the addition of heparin to the feed extends the total period of feeding attainable.
Authors:
James A Catton; John Davies; Brian M Dobbins; Jonathan M Wood; Michael J McMahon; Dermot Burke
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2005-11-28
Journal Detail:
Title:  Clinical nutrition (Edinburgh, Scotland)     Volume:  25     ISSN:  0261-5614     ISO Abbreviation:  Clin Nutr     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-16     Completed Date:  2006-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309603     Medline TA:  Clin Nutr     Country:  England    
Other Details:
Languages:  eng     Pagination:  394-9     Citation Subset:  IM    
Affiliation:
Academic Unit of Surgery, The General Infirmary at Leeds, Great George Street, Leeds, LS1 3EX, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Double-Blind Method
Female
Heparin / administration & dosage*
Humans
Hydrocortisone / administration & dosage
Male
Middle Aged
Parenteral Nutrition / adverse effects,  instrumentation,  methods*
Thrombophlebitis / epidemiology,  etiology,  prevention & control
Treatment Outcome
Veins
Chemical
Reg. No./Substance:
50-23-7/Hydrocortisone; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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