[Prevalence of malnutrition in medical and surgical wards of a university hospital]. / Prevalencia de malnutrición en los servicios médicos y quirúrgicos de un hospital universitario.

INTRODUCTION: Malnutrition is frequently found in hospitals, where is related to poor outcomes. There are contradictory data about if prevalence of malnutrition is greater in surgical or medical patients. The aim of this study is to know the prevalence of malnutrition in both groups of patients. METHODS: The nutritional status of 189 patients from medical and surgical wards was assessed with Subjective Global Assessment, and data about sex, age, length of hospital stay, mortality, diseases, and wards of admission were collected. Qualitative variables were compared with chi-square test, and independent quantitative variables with Student's t test. P < 0.05 was accepted as significative. RESULTS: The prevalence of malnutrition was 40.2%. Malnourished patients have lost 7.3% of their weight, 67.1% referred a diminished oral intake, and 53.9% anorexia. Malnutrition was significatively associated to male sex, greater length of stay, and cancer. Prevalence and severity of malnutrition were similar in medical and surgical wards, and malnourished patients just differed in diseases (chronic diseases in medical; surgical procedures and cancer in surgery). CONCLUSIONS: Malnutrition is equally prevalent in medical and surgical wards, probably due to different but highly frequent risk factors, and is related to a longer hospital stay.

[II BAXTER-SENPE workshop: peripheral parenteral nutrition]. / II Mesa de Trabajo Baxter-SENPE: Nutrición Parenteral Periférica.

During the II BAXTER-SENPE workshop, a multidisciplinary nutrition expert committee discusses on indications, advantages and drawbacks of Peripheral Parenteral Nutrition (PPN), being defined as PN compounded by the three essential elements, vitamins, and minerals. Its composition implies a CH: lipids ratio of 60:40, a limited lipid daily intake (1.3 g/kg of body weight/day) and no more than 30% of total calories), and a nitrogen load not higher than 10 g of nitrogen in a maximum volume of 2500 mL. PPN can be administered by the peripheral route since its osmolarity is lower than 800 mOsm/L and pH is 6.0-7.4; in this way, possible adverse affects of central venous accesses are prevented. Currently, PPN by represent up to 50% of all PNs prescribed at a hospital Studies on efficacy, safety and pharmacoeconomic show that PPN is very useful therapeutic resource in certain clinical situations, both medical and surgical, to prevent metabolic-nutritional worsening of the patient, thus having an impact on significant reduction of complications, the number of interventions, and hospital stay.

Chylous ascites following heart transplantation.

We report a case of chylous ascites in a 52-year-old woman after an orthotopic heart transplantation. The patient was successfully managed with conservative treatment including dietetic measures and repeated paracentesis. The potential aetiopathological factors involved and other implications for cardiac transplant patients are discussed.

[Intra-dialysis parenteral nutrition in chronic renal patients: consensus SEN-SENPE]. / Nutrición parenteral intradiálisis en el enfermo renal crónico: consenso SEN-SENPE.

Given the high prevalence of the hyponutrition state among haemodialysis patients and knowing that this implies an increase in the rates of infection, hospitalisation and hospital stay, which translates into an increase in global morbid-mortality, the Spanish Society of Nephrology (SEN) and the Spanish Society of Parenteral and Enteral Nutrition (SENPE) have reached a consensus on the indications, contraindications, and limitations of Intra-Dialysis Parenteral Nutrition (IDPN.) This consensus considers IDPN as a valid alternative to other types of nutritional support when these show their lack of efficacy. The bases are set regarding the timing of nutritional intervention with IDPN, its ideal composition, the time of administration, its controls, follow-up schedules, and the time at which the nutritional support has to be discontinued.

Prevalencia de malnutrición en los servicios médicos y quirúrgicos de un hospital universitario / Prevalence of malnutrition in medical and surgical wards of a university hospital

Introducción: La malnutrición es frecuente en los hospitales y se asocia a peores resultados clínicos. Existen datos contradictorios sobre si la prevalencia de malnutrición es mayor en los servicios médicos o quirúrgicos. Estudiamos la prevalencia de este trastorno en pacientes de ambos tipos de servicio. Métodos: Se evaluó el estado nutricional de 189 pacientes de servicios médicos y quirúrgicos mediante la Valoración Global Subjetiva, y se recogieron datos sobre su sexo, edad, estancia hospitalaria, mortalidad, patología y servicio de ingreso. Las variables cualitativas se compararon mediante chi-cuadrado, y las variables cuantitativas independientes mediante el test t de Student. Consideramos significativa una p < 0,05.Resultados: La prevalencia de malnutrición fue 40,2%.Los pacientes malnutridos habían perdido un 7,3% de peso, el 67,1% habían reducido su ingesta oral, y el 53,9% referían anorexia. La malnutrición se asoció significativamente al sexo masculino, a una estancia hospitalaria más larga, y a padecer enfermedades crónicas o cáncer. La prevalencia y gravedad de malnutrición fueron similares en servicios médicos y quirúrgicos, pero presentaron distintas patologías de base (enfermedades crónicas en los servicios médicos, intervenciones y cáncer en los quirúrgicos).Conclusiones: La malnutrición es igual de frecuente entre pacientes médicos y quirúrgico, probablemente debido a diferentes pero igualmente frecuentes factores de riesgo, y se asocia a una estancia hospitalaria más larga

Introduction: Malnutrition is frequently found in hospitals, where is related to poor outcomes. There are contradictory data about if prevalence of malnutrition is greater in surgical or medical patients. The aim of this study is to know the prevalence of malnutrition in both groups of patients. Methods: The nutritional status of 189 patients from medical and surgical wards was assessed with Subjective Global Assessment, and data about sex, age, length of hospital stay, mortality, diseases, and wards of admission were collected. Qualitative variables were compared with chi-square test, and independent quantitative variables with Student’s t test. P < 0.05 was accepted as significative. Results: The prevalence of malnutrition was 40.2%.Malnourished patients have lost 7.3% of their weight, 67.1% referred a diminished oral intake, and 53.9% anorexia. Malnutrition was significatively associated to male sex, greater length of stay, and cancer. Prevalence and severity of malnutrition were similar in medical and surgical wards, and malnourished patients just differed in diseases (chronic diseases in medical; surgical procedures and cancer in surgery).Conclusions: Malnutrition is equally prevalent in medical and surgical wards, probably due to different buthighly frequent risk factors, and is related to a longer hospital stay

II Mesa de Trabajo Baxter-SENPE: Nutrición Parenteral Periférica / II Baxter-SENPE workshop. Peripheral parenteral nutrition

En la II Mesa de Trabajo BAXTER-SENPE un grupo multidisciplinario de expertos en nutrición debate sobre las indicaciones, ventajas e inconvenientes de la Nutrición Parenteral Periférica (NPP), definiéndose ésta como una NP compuesta por los tres principios inmediatos, vitaminas y minerales. Su composición implica una razón H d C: Lípidos de 60:40, un límite en el aporte diario lipídico (1,3 g/kg de peso/día y no más del 30 % de las calorías totales) y una carga nitrogenada que no supere los 10 gramos de nitrógeno en un volumen máximo de 2500 ml. La NPP permite su administración por vía periférica debido a presentar una osmolaridad menor de 800 mOsml y un pH entre 6,0 y 7,4; de esta forma evita los posibles efectos deletéreos del acceso venoso central. A día de hoy la NPP puede llegar a suponer el 50 % de las NPs prescritas en un centro hospitalario. Los estudios de eficacia, seguridad y farmacoeconomía demuestran que la NPP es un recurso terapéutico muy útil en determinadas situaciones clínicas tanto médicas como quirúrgicas para evitar el deterioro metabólico-nutricional del paciente lo que repercute en una reducción significativa de las complicaciones, disminuye significativamente el número de exploraciones y acorta la estancia hospitalaria

During the II BAXTER-SENPE workshop, a multidisciplinary nutrition expert committee discusses on indications, advantages and drawbacks of Peripheral Parenteral Nutrition (PPN), being defined as PN compounded by the three essential elements, vitamins, and minerals. Its composition implies a CH: lipids ratio of 60:40, a limited lipid daily intake (1.3 g/kg of body weight/day) and no more than 30% of total calories), and a nitrogen load not higher than 10 g of nitrogen in a maximum volume of 2500 mL. PPN can be administered by the peripheral route since its osmolarity is lower than 800 mOsm/L and pH is 6.0- 7.4; in this way, possible adverse affects of central venous accesses are prevented. Currently, PPN by represent up to 50% of all PNs prescribed at a hospital. Studies on efficacy, safety and pharmacoeconomic show that PPN is very useful therapeutic resource in certain clinical situations, both medical and surgical, to prevent metabolic-nutritional worsening of the patient, thus having an impact on significant reduction of complications, the number of interventions, and hospital stay