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Triple lumen catheters for parenteral nutrition
N M Vo1, M Waycaster, J Godfrey
1Surgical Services, Veterans Administration Medical Center, Johnson City, Tenn.
Southern Medical Journal
|February 1, 1988
Summary
Triple lumen catheters (TLCs) are safe for parenteral nutrition, with a low infection rate. Catheter tips do not require culturing in afebrile patients without other infections, but risks increase after two weeks.
Area of Science:
- Medical Science
- Clinical Practice
- Infectious Disease
Background:
- Triple lumen catheters (TLCs) are essential for parenteral nutrition.
- Assessing the safety and infection risk associated with TLC use is crucial for patient care.
Purpose of the Study:
- To evaluate the incidence of infection and contamination associated with TLCs used for parenteral nutrition.
- To determine the necessity of culturing TLC tips in specific patient groups.
- To identify risk factors for TLC-related infections.
Main Methods:
- Retrospective chart review of 61 patients with 101 TLCs used for parenteral nutrition.
- Categorization of patients based on TLC tip cultures and infection status.
- Monitoring of temperature, white blood cell (WBC) count, alkaline phosphatase, and SGOT levels.
Main Results:
- The incidence of catheter-related sepsis was 4%, with 14% of tips contaminated.
- Patients with culture-negative TLC tips and no other infection source remained afebrile.
- TLC removal did not consistently lead to defervescence or decreased WBC in infected or contaminated groups.
- Infection or contamination risk increased significantly for TLCs used longer than two weeks.
Conclusions:
- TLCs can be safely used for parenteral nutrition with a low infection rate.
- Routine culturing of TLC tips is unnecessary for afebrile patients without other infection sources.
- TLCs can remain in place in afebrile patients, but prolonged use (over two weeks) elevates infection risk.