Indwelling venous catheters are frequently used in the treatment and management of critically ill patients. However, if specific techniques and principles are not followed in the insertion and maintenance of the catheter, it can become a hazard to the patient it was designed to aid. Phlebitis,1 thrombosis,2,3 embolism,2,4 and cannula sepsis5,6 may occur. Recent recommendations for prevention of these complications have emphasized prompt removal of the catheter after 48 to 96 hours of use.6,7
The need for long-term catheterization in chronically ill patients prompted this prospective study. The development of techniques of catheter insertion and long-term maintenance, which allowed the prolonged infusion of hypertonic nutrient solutions,8,9 forms the basis of this report.
Materials and Methods
Patients.—Twenty-five adults with chronic complicated gastrointestinal disease requiring long-term total parenteral nutrition were studied.Catheterization.—All catheters (No. 14 needle with No. 16 catheter, 8 inches long) were