The benefits of central vein feeding and long term access to the circulation.

Although parenteral nutrition can be safely administered by peripheral vein for long periods most workers find it a difficult technique primarily because of phlebitis induced by the nutrient solutions. Additionally the need for immobilisation of an arm for at least part of the day restricts the patient's mobility. On the other hand, nutrition through a catheter inserted into a large vein, with its tip positioned in the superior vena cava, allows the infusion of large volumes of nutrients with only minimal risk of phlebitis. If the catheter is inserted through the subclavian or jugular veins there is no need to immobilise a limb and, using portable systems the patient can remain mobile, even whilst infusion is occurring. It is the development of these latter techniques that has led to Home Parenteral Nutrition being a feasible treatment. The hazards associated with central vein nutrition can be minimised by skillful insertion of the catheters and meticulous maintenance thereafter.