In:
Journal of Parenteral and Enteral Nutrition, Wiley, Vol. 20, No. 1 ( 1996-01), p. 20-24
Abstract:
Background: This two‐part study initially evaluated complications associated with catheters inserted via upper extremity veins. The second prospective phase compared thrombotic risk of peripheral catheter tips vs a central vein terminus. Methods: Patients from public institutions with infectious diseases were observed throughout their inpatient and outpatient use of IV catheters. Seventy‐two and 39 patients enrolled in phase 1 and phase 2, respectively. Phase 1 consisted of prospective observations and analysis of complications and associated risk factors. Phase 2 randomized patients to a catheter tip location in the superior vena cava or the axillosubclavian‐innominate vein and compared the incidence of thrombosis, phlebitis, and infection. Results: In phase 1, there was an increased risk of thrombosis with peripheral tip localization (61% vs 16%, p 〈 .05). Phase 2 confirmed increased thrombosis with tips in the axillosubclavian‐innominate vein compared with the superior vena cava (60% vs 21%, p 〈 .05) with an improved survival for central tip catheters (p 〈 .02). Catheters associated with thrombosis were more likely to become infected (r = 0.48, p 〈 .02). Conclusions: The experience supports use of the long arm catheter as an effective device for parenteral therapy. A novel method for placing these catheters makes most patients candidates for this approach. Placing a long arm‐catheter's tip in the central venous circulation reduces the risk of thrombosis. A high incidence of tip misdirection indicates a need for radiographic confirmation before use. (Journal of Parenteral and Enteral Nutrition 20 :20–24, 1996)
Type of Medium:
Online Resource
ISSN:
0148-6071
,
1941-2444
DOI:
10.1177/014860719602000120
Language:
English
Publisher:
Wiley
Publication Date:
1996
detail.hit.zdb_id:
2170060-6
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