To tunnel or not to tunnel catheters for parenteral nutrition

The effect of subcutaneous catheter tunnelling on the incidence of catheter sepsis and on catheter life span in the absence of a nutrition team was determined in a prospective controlled clinical trial. Eighty one patients who received 92 courses of parenteral nutrition had 110 catheters inserted. Alternate catheters were tunnelled. Four patients who received parentheral nutrition for less than 48 hours were excluded from the study. Catheter related sepsis occurred in one tunnelled (1.8%) and 4 non-tunnelled catheters (7.6%) (P greater than 0.05 NS). Mean life span of tunnelled catheters was 21 days (range 5-37 days) compared to 12.6 days for non-tunnelled (range 3-19 days) (P less than 0.05). Six non-tunnelled catheters became displaced, a complication which did not occur with tunnelled catheters (P less than 0.01). In conclusion subcutaneous tunnelling of silicone catheters prolongs catheter life span but does not significantly influence catheter sepsis.