Total nutrition by peripheral vein--the lipid system.

A means for providing total nutrition is described in which 10% soybean oil-eggyolk phosphatide-glycerol emulsion (Intralipid) and a solution of 5% dextrose in 5% protein hydrolysate are given simultaneously into a peripheral vein, utilizing two giving sets united by a Y-connector at the needle. No ketonuria occurred, and there were no side effects from the lipid emulsion. Advantages of this system include absence of significant peripheral phlebitis, avoidance of the hazards of caval catheters, and absence of the complications of hypertonic solutions. Disadvantages include restricted forearm movement and frequent regulation of flow-rates.This system was used in 23 patients for periods of 4 to 78 days (mean 16.3 days). Weight gain and healing occurred, and all survived but one patient who died of myocardial infarction following successful surgical closure of an enterocolocutaneous fistula. The lipid system adds another method to the measures available for the management of major nutritional problems.