Reduction of postinfusion venous endothelial injury with intralipid

Hypertonic dextrose solutions, an essential part of parenteral nutrition infusions, have a sclerogenic effect upon vascular endothelium and frequently cause phlebitis or thrombosis, or both. Buffering D10W and D20W infusions to a pH of 7.4 slightly reduces the severity of endothelial injury. Infusion of Intralipid into canine veins during a 24 hour period produces negligible evidence of endothelial injury. Infusing concentrated dextrose solutions simultaneously through the same vein with Intralipid appreciably minimizes endothelial injury; when combined with bicarbonate buffering, the beneficial reduction of endothelial damage is significant (p less than 0.001) as seen on SEM and LM. In our opinion, long term infusion of Intralipid simultaneously with hypertonic dextrose is preferable to the currently recommended technique of separate infusion.