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Peripheral Vein Complications in Patients Receiving Amino Acid/ Dextrose Solutions

Departments of Surgery, Urology, and Biostatistics, The University of Texas System Cancer Center. The M.D.Anderson Hospital and Tumor Institute, Department of Surgery, The University of Texas Medical School at Houston

John M. Daly, M.D.

Departments of Surgery, Urology, and Biostatistics, The University of Texas System Cancer Center. The M.D.Anderson Hospital and Tumor Institute, Department of Surgery, The University of Texas Medical School at Houston

Edward M. Copeland, III, M.D.

Departments of Surgery, Urology, and Biostatistics, The University of Texas System Cancer Center. The M.D.Anderson Hospital and Tumor Institute, Department of Surgery, The University of Texas Medical School at Houston

Douglas E. Johnson, M.D.

Departments of Surgery, Urology, and Biostatistics, The University of Texas System Cancer Center. The M.D.Anderson Hospital and Tumor Institute, Department of Surgery, The University of Texas Medical School at Houston

Andrew C. Voneshenbach, M.D.

Departments of Surgery, Urology, and Biostatistics, The University of Texas System Cancer Center. The M.D.Anderson Hospital and Tumor Institute, Department of Surgery, The University of Texas Medical School at Houston

Dennis Johnston, PH.D.

Departments of Surgery, Urology, and Biostatistics, The University of Texas System Cancer Center. The M.D.Anderson Hospital and Tumor Institute, Department of Surgery, The University of Texas Medical School at Houston

Ben Rundell, B.S.

Departments of Surgery, Urology, and Biostatistics, The University of Texas System Cancer Center. The M.D.Anderson Hospital and Tumor Institute, Department of Surgery, The University of Texas Medical School at Houston

Stanley J. Dudrick, M.D.

Departments of Surgery, Urology, and Biostatistics, The University of Texas System Cancer Center. The M.D.Anderson Hospital and Tumor Institute, Department of Surgery, The University of Texas Medical School at Houston

, The incidence and severity of peripheral vein phlebitis was evaluated in patients receiving infusions of amino acids alone (1.4 g/kg/day)(group I), amino acids (1.4 g/kg/day) plus 5% dextrose (Group II) and 5% dextrose alone (Group III). Ninety-three patients with carcinoma of the bladder were randomized to receive one of three peripheral parenteral nutrition solutions which were infused predominantly via scalp-vein needles. Peripheral parenteral nutrition solutions contained sodium and potassium chloride as necessary to maintain normal serum electrolyte levels. The osmolality of each solution was calculated. Peripheral intravenous sites were evaluated every 8 hr and at the time of each intravenous site change. The incidence of infiltration, phlebitis and its' severity was recorded and graded zero (no complications) to 4 (severe complications). An intravenous cannula was discontinued if infiltration or a grade 2 or greater phlebitis occurred. The mean osmolality of the solutions were (group I) 450 to 500 mosm/liter, (group II) 713 to 763 mosm/liter and (group III) 369 mosm/liter. The mean duration of infusion was 9.0 + 0.4, 9.1 + 0.4, and 8.7 + 0.5 days, respectively, and the mean number of intravenous site changes were 6.1 + 0.3, 5.8 + 0.3, and 5.6 + 0.3. respectively. Infiltration preceded 57, 56, and 58%, of all intravenous site changes and the incidence and severity of peripheral vein phlebitis was similar for all three groups. Sixty patients who received their infusions via plastic indwelling catheters for a mean duration of 2.6 + 1.0, 2.3 + 1.0, and 2.8 + 1.0 days had an 86, 71, and 76% incidence of grade two or greater phlebitis, respectively. There was no significant difference in the incidence of infiltration and phlebitis in patients receiving peripheral parenteral infusions of amino acids alone, amino acids plus dextrose, and 5% dextrose alone.

Journal of Parenteral and Enteral Nutrition, Vol. 7, No. 2, 159-162 (1983)
DOI: 10.1177/0148607183007002159


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				B.M. Hogbin, A.M. Smith, and A.H. Craven An Evaluation of Peripheral Essential Amino Acid Infusion following Major Surgery JPEN J Parenter Enteral Nutr, September 1, 1984; 8(5): 511 - 514. [Abstract] [PDF]