Chemical phlebothrombosis of large veins. A not uncommon complication of total parenteral nutrition
H. R. Freund
Thrombosis of large veins during total parenteral nutrition (TPN) is
considered uncommon. Recently, clinical and phlebographic evidence of
large-vein thrombosis were encountered in five patients among 200
consecutive patients receiving TPN. The symptoms, signs, and phlebographic
findings occurred within one to two days, sometimes as early as a few hours
after cannulation. It is suggested that thrombosis of large veins during
TPN is not uncommon and is the result of chemical phlebothrombosis due to a
hypersensitivity reaction of the venous wall to the polyvinyl catheter
material. Early removal of the offending catheter is advocated.
