The purpose of this study was to determine in a randomized, prospective manner whether administration of total parenteral nutrition (TPN) via multilumen catheters increases the risk of catheterrelated sepsis (CRS). All patients receiving hyperalimentation during a 24-month period were randomized to receive either a double-lumen catheter (DLC) or a triple-lumen catheter (TLC). A total of 101 catheters were placed in 79 patients, of which 49 were DLCs and 52 were TLCs. The patients with DLCs received a total of 784 days of TPN, whereas patients with TLCs received a total of 754 days of TPN. CRS was associated with one (2.0%) of the 49 DLCs vs. one (1.9%) of the 52 TLCs. In comparison, the rate of CRS associated with single-lumen catheters (historical control) at our institution was 1.4% (P ú .90). We conclude that the use of multilumen catheters in TPN therapy does not result in an increased risk of CRS.Total parenteral nutrition (TPN) is required in many hospitalnity to participate in this open, randomized, prospective trial.Patients were randomized to receive catheters according to their ized patients who cannot meet their nutritional needs enterally. An important potential complication related to TPN administrasocial security numbers -those with an even number received tion is catheter-related sepsis (CRS) [1]. Some studies have a double-lumen catheter (DLC) , while those with an odd numsuggested that the risk of CRS is increased by the use of tripleber received a TLC. Informed consent was obtained from each lumen catheters (TLCs) [2 -4]. Previous studies have shown patient in accordance with Veterans Administration guidelines. that administration of TPN through TLCs is associated with aThe study was approved by the Department of Veterans Affairs higher risk of CRS than is administration through single-lumen (Long Beach) Human Studies Committee and Research and catheters (SLCs) [2 -4]. The rate of CRS related to TLCs has Development Committee. been reported to be as high as 10% -25%, compared with a Both DLCs and TLCs were polyurethane 7F catheters rate of 0 -6% associated with SLCs [2 -4]. Thus, the use of (Arrow International, Reading, PA) that were made to be in-TLC in TPN therapy has been deemed unsafe by some investiserted over a guide wire by means of the Seldinger technique. gators. Because many of the patients who require TPN therapy All catheters were inserted by surgical or medical house staff are critically ill and have poor venous access, the use of TLCs by using a sterile technique and were sutured to the skin. Strict in these patients would allow additional access ports for admincompliance with the sterile technique was ensured by having istration of compatible medications and intravenous solutions the nutritional support team (NST) nurse present at all proceand eliminate the need for additional intravenous catheters.dures. The catheter was inserted into the internal jugular or the The purpose of this randomized, prospective study was to subclavian vein, depending on the preference of the individu...

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