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J R Soc Med. 1987 July; 80(7): 430–433.
PMCID: PMC1290905

Parenteral nutrition via peripheral veins: a feasibility study.

Abstract

Twenty patients who had undergone uncomplicated surgery of moderate severity were randomly allocated to two groups (both n = 10) who were fed using a peripheral vein for up to six days. Group I received, each day, a nutrient solution providing 10 grams of nitrogen as Perifusin (E Merck Ltd) and 1400 calories as dextrose and Intralipid (Kabivitrum Ltd) with an osmolality of 490 mosmol/kg. Group II received only 15 grams of nitrogen per day as Perifusin with an osmolality of 376 mosmol/kg. The mean (+/- s.e. mean) nitrogen balance over the study was similar in both groups, in Group I being -1.23 +/- 0.89, and in Group II being -1.05 +/- 1.08 g (P greater than 0.05 Mann-Whitney U test). The nutrient mixture given to Group I resulted in elevated levels of serum 3-hydroxybutyrate and lower levels of serum non-esterified fatty acids. These data suggest that lipolysis and ketogenesis were suppressed. There was no significant difference in serum lactate levels in either group. Venous thrombophlebitis at the infusion site was assessed daily using Maddox's criteria, with a minimal degree of inflammation occurring in either group. This preliminary study suggests that a total parenteral feeding regimen may be designed for peripheral vein infusion. Further studies are indicated.

Full text

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Macfie J. Energy requirements of surgical patients during intravenous nutrition. Ann R Coll Surg Engl. 1984 Jan;66(1):39–42. [PMC free article] [PubMed]
  • Elwyn DH, Kinney JM, Askanazi J. Energy expenditure in surgical patients. Surg Clin North Am. 1981 Jun;61(3):545–556. [PubMed]
  • Fujiwara T, Kawarasaki H, Fonkalsrud EW. Reduction of postinfusion venous endothelial injury with intralipid. Surg Gynecol Obstet. 1984 Jan;158(1):57–65. [PubMed]
  • Peaston MJ. Maintenance of metabolism during intensive patient care. Postgrad Med J. 1967 Apr;43(498):317–338. [PMC free article] [PubMed]
  • Maddox RR, Rush DR, Rapp RP, Foster TS, Mazella V, McKean HE. Double-blind study to investigate methods to prevent cephalothin-induced phlebitis. Am J Hosp Pharm. 1977 Jan;34(1):29–34. [PubMed]
  • Blackburn GL, Flatt JP, Clowes GH, O'Donnell TE. Peripheral intravenous feeding with isotonic amino acid solutions. Am J Surg. 1973 Apr;125(4):447–454. [PubMed]
  • Schulte WJ, Condon RE, Kraus MA. Positive nitrogen balance using isotonic crystalline amino acid solution. Arch Surg. 1975 Aug;110(8):914–915. [PubMed]
  • Craig RP, Tweedle D, Davidson HA, Johnston ID. Intravenous glucose, aminoacids, and fat in the postoperative period. A controlled evaluation of each substrate. Lancet. 1977 Jul 2;2(8027):8–11. [PubMed]
  • O'Connell RC, Morgan AP, Aoki TT, Ball MR, Moore FD. Nitrogen conservation in starvation: graded responses to intravenous glucose. J Clin Endocrinol Metab. 1974 Sep;39(3):555–563. [PubMed]
  • Ching N, Mills CJ, Grossi C, Angers JW, Jham G, Zurawinsky H, Nealon TF., Jr The absence of protein--sparing effects utilizing crystalline amino acids in stressed patients. Ann Surg. 1979 Nov;190(5):565–570. [PubMed]
  • McDougal WS, Wilmore DW, Pruitt BA., Jr Effect of intravenous near isosmotic nutrient infusions on nitrogen balance in critically ill injured patients. Surg Gynecol Obstet. 1977 Sep;145(3):408–414. [PubMed]
  • Greenberg GR, Marliss EB, Anderson GH, Langer B, Spence W, Tovee EB, Jeejeebhoy KN. Protein-sparing therapy in postoperative patients. Effects of added hypocaloric glucose or lipid. N Engl J Med. 1976 Jun 24;294(26):1411–1416. [PubMed]
  • Askanazi J, Carpentier YA, Elwyn DH, Nordenström J, Jeevanandam M, Rosenbaum SH, Gump FE, Kinney JM. Influence of total parenteral nutrition on fuel utilization in injury and sepsis. Ann Surg. 1980 Jan;191(1):40–46. [PubMed]
  • Jeejee hoy KN, Anderson GH, Nakhooda AF, Greenberg GR, Sanderson I, Marliss EB. Metabolic studies in total parenteral nutrition with lipid in man. Comparison with glucose. J Clin Invest. 1976 Jan;57(1):125–136. [PMC free article] [PubMed]
  • Sim AJ, Wolfe BM, Young VR, Clarke D, Moore FD. Glucose promotes whole-body protein synthesis from infused aminoacids in fasting man. Isotopic demonstration. Lancet. 1979 Jan;1(8107):68–72. [PubMed]
  • Skillman JJ, Rosenoer VM, Pallotta JA, Young JB, Young VR, Long PC, Wilentz K, Munro HN. Effect of isocaloric fat or glucose on albumin synthesis and nitrogen balance in patients receiving amino acid infusion. Surgery. 1981 Feb;89(2):168–174. [PubMed]
  • Arnold RE, Elliot EK, Holmes BH. The importance of frequent examination of infusion sites in preventing postinfusion phlebitis. Surg Gynecol Obstet. 1977 Jul;145(1):19–20. [PubMed]
  • Frazer IH, Eke N, Laing MS. Is infusion phlebitis preventable? Br Med J. 1977 Jul 23;2(6081):232–232. [PMC free article] [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press