Parenteral nutrition.

The effect of subcutaneous catheter tunnelling on the incidence of catheter sepsis and on catheter life span in the absence of a nutrition team was determined in a prospective controlled clinical trial. Eighty one patients who received 92 courses ofparenteral nutrition had 110 catheters inserted. Alternate catheters were tunnelled. Four patients who receivedparentheral nutritionfor less than 48 hours were excludedfrom the study. Catheter related sepsis occurred in one tunnelled (1.8%) and 4 non-tunnelled catheters (7.6%) (P>0.O5NS). Mean life span oftunnelled catheters was 21 days (range 5-37 days) compared to 12.6 days for nontunnelled (range 3-19 days) (P<0.05). Six non-tunnelled catheters became displaced, a complication which did not occur with tunnelled catheters (P<0.0J). In conclusion subcutaneous tunnelling of silicone catheters prolongs catheter life span but does not significantly influence catheter sepsis.