Transdermal Glyceryl Trinitrate to Allow Peripheral Total Parenteral Nutrition: A Double-Blind Placebo Controlled Feasibility Study

• Published in: Journal of the Royal Society of Medicine
• Main Authors: Khawaja, H T, Williams, J D, Weaver, P C
• Format: Article in Journal/Newspaper
• Language: English
• Published: SAGE Publications 1991
• Subjects: General Medicine; GTN-P
• Online Access: http://dx.doi.org/10.1177/014107689108400205; http://journals.sagepub.com/doi/pdf/10.1177/014107689108400205

Seventy-two consecutive patients requiring total parenteral nutrition (TPN) were randomized to two groups. Group A received daily a peripheral intravenous regimen which provided 10 g nitrogen and 1400 non-nitrogen kcal (5.9 MJ). Group B received daily a peripheral intravenous regimen which delivered 9.4 g nitrogen and 1900 non-nitrogen kcal (8.0 MJ). Each group was further randomized to receive a self-adhesive patch of transdermal glyceryl trinitrate (GTN) or an identical placebo. Infusion survival was the main end-point. For group A, the median time of infusion survival was 74 h (range: 58–100) in the control group compared with 108 h (range: 68–156) in the group that received transdermal GTN (P < 0.001). For group B, the median infusion survival was 67 h (range: 46–92) in the control group compared with 103 h (range: 66–151) in the treatment group (P < 0.001). TPN is feasible via peripheral veins and the incidence of infusion failure can be effectively reduced by transdermal GTN.