Do heparin, hydrocortisone, and glyceryl trinitrate influence thrombophlebitis during full intravenous nutrition via a peripheral vein?

The aim of this prospective, randomized study was to determine if the addition of heparin and hydrocortisone, and the application of a topical glyceryl trinitrate patch over the catheter site (triple therapy) would results in a reduced incidence of thrombophlebitis during i.v. nutrition through a peripheral vein. Forty-six patients were randomized to receive either standard i.v. nutrition (i.v.N)(1200 mosm/kg) (control group, n = 23), or i.v.N plus triple therapy (study group, n = 23). The patient's arm was examined daily, and the catheter was removed if signs of thrombophlebitis were evident. The two groups were well matched in terms of age and gender, as well as indication for feeding and total days of i.v.N supplied. The catheters in the study group survived longer (p < .0001), and resulted in a lower incidence of thrombophlebitis (p < .05). The time of onset of thrombophlebitis was delayed in the study group (p < .0001). It is recommended that heparin, hydrocortisone, and a glyceryl trinitrate patch should be administered to all patients receiving i.v. nutrition via a fine-bore peripheral catheter.