Intravenous feeding catheters

Central venous catheters are generally inserted in the operating theater or emergency room for reasons primarily related to life support rather than nutrition. The site of vascular access is usually the internal jugular or the subclavian vein.

During critical illness, the catheter is multipurpose. It is used to deliver drugs and other infusions including blood products. Usually it is a multiple-lumen catheter, with one lumen dedicated exclusively to nutritional fluids. The catheter is not tunneled so that it can be changed over a guidewire.

If the only reason to maintain a central vascular catheter is artificial long-term nutrition, a silicon catheter, tunneled for prevention of infection, should be considered. Chapter References

Chassard, D., Guiraud, M., Gauthier, J., Gelas, P., Berrada, K.R., and Bouletreau, P. (1994). Effects of intravenous medium-chain triglycerides on pulmonary gas exchanges in mechanically ventilated patients. Critical Care Medicine, 22, 248-51.

lapichino, G., et al. (1984). The main determinants of nitrogen balance during total parenteral nutrition in critically ill injured patients. Intensive Care Medicine, 10, 251-4.

Nitenberg, G. (1993). Enteral and parenteral nutrition. In Pathophysiologic foundations of critical care (ed. M.R. Pinsky and J.F.A. Dhainaut), pp. 42-81. Williams & Wilkins, Baltimore, MD.

Wilmore, D.W. and Carpentier, Y.A. (ed.) (1993). Metabolic support of the critically ill patient. Springer-Verlag, Berlin.

Wilmore, D.W. and Carpentier, Y.A. (1994). Round Table Conference on Metabolic Support of the Critically Ill Patient. Intensive Care Medicine, 20, 298-9.

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