Bacteriology and phlebography in catheterization for parenteral nutrition. A prospective study

A total of 42 central venous catheterizations in 32 patients were subjected to a prospective study with respect to bacteriologic and thrombotic complications. Growth of bacteria was found in blood cultures in 3 cases (7%) and in cultures from catheter tips in 15 cases (36%). In 25 cases (59%) phlebography revealed partial or complete thrombosis of the central vein. In 7 cases phlebography could not be performed because of blockage of the catheter (5 cases) or thrombophlebitis (2 cases). There was no relationship between bacteriologic and thrombotic complications. The frequency of bacteraemia is in agreement with earlier observations whereas the frequency of catheter-related thrombosis is much higher. This might be due to the fact that phlebography was performed at the time of catheter removal. The presence of catheter-related thrombosis is potentially hazardous as a source of microembolism. Prophylactic anticoagulant therapy in long-term catheterizations for parenteral nutrition is therefore suggested.