Which of the following is preferred cannulation site for total parenteral nutrition: September 2007

Ans. D: External jugular vein Chronic PN (parenteral nutrition) is performed through a central intravenous catheter, usually through the subclan or jugular vein with the tip of the catheter at the superior vena cava without entering the right atrium. Most intensive care physicians and anaesthetists our cannulation of internal or external jugular veins as these vessels are easily accessible. They have the disadvantage that the exit site is situated inconveniently on the side of the neck, where repeated movements result in disruption of the dressing with the attendant risk of sepsis. The infraclavicular subclan approach is more suitable for feeding as the catheter then lies flat on the chest wall, which optimizes nursing care.