Peripheral vein infusion of dextrose/amino acid solutions +/- 20% fat emulsion

The purpose of this study was to evaluate the incidence of phlebitis occurring during peripheral infusion of nutrient solutions with and without 20% fat emulsions. Eighty patients were randomly assigned to one of four groups: (1) dextrose/amino acids-630 mOsmol/liter; (2) dextrose/amino acids/fat emulsion-706 mOsmol/liter; (3) dextrose/amino acids-882 mOsmol/liter and; (4) dextrose/amino acids/fat emulsion-983 mOsmol/liter. The peripheral infusion site was examined daily and the number of changes in infusion sites were recorded and the degree of phlebitis encountered was graded. The four groups were similar in the mean number of iv site changes per patient and per day. The average grade of phlebitis was similar (0.23-0.27 events/day) among the four groups. Infiltration occurred more frequently with butterfly needle while phlebitis occurred more frequently with plastic angiocatheters. Patients appeared to tolerate peripheral infusion with high osmolar solutions just as well as lower osmolar solutions. Concurrent infusion with a 20% fat emulsion did not alter the number of iv site changes or the incidence or degree of phlebitis reported and thus, did not appear to have a protective effect on the vein when infused with dextrose/amino acid solutions.