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Do Patients With a Baseline Clinical Condition Warranting the Cautious Use of Parenteral Nutrition Develop Subsequent Metabolic Complications?
Solomon, Diana M; Hollands, James M; Siemianowski, Laura A; Smith, Colleen E; Song, Richard J; Bingham, Angela L.
Afiliação
  • Solomon DM; 1 Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, Pennsylvania, USA.
  • Hollands JM; 1 Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, Pennsylvania, USA.
  • Siemianowski LA; 2 Cooper University Hospital, Camden, New Jersey, USA.
  • Smith CE; 2 Cooper University Hospital, Camden, New Jersey, USA.
  • Song RJ; 2 Cooper University Hospital, Camden, New Jersey, USA.
  • Bingham AL; 2 Cooper University Hospital, Camden, New Jersey, USA.
Nutr Clin Pract ; 32(3): 400-406, 2017 Jun.
Article em En | MEDLINE | ID: mdl-28537512
BACKGROUND: The American Society for Parenteral and Enteral Nutrition Adult Nutrition Support Core Curriculum describes clinical conditions that warrant cautious use of parenteral nutrition (CCWCPN). The Core Curriculum authors acknowledge there is no evidence for specific criteria suggested for the clinical conditions. Consequently, the purpose of this study was to determine the impact of a baseline CCWCPN on the development of subsequent metabolic complications in patients receiving parenteral nutrition (PN). METHODS: Adult patients initiated on PN from May 2014 to July 2015 at Cooper University Hospital were included in this retrospective study. The impact of a CCWCPN on the development of the following was determined: acid-base disturbances, hepatobiliary complications, hypercapnia, hyperchloremia, hyperglycemia, hypernatremia, hypertriglyceridemia, hypochloremia, hypoglycemia, hypokalemia, hypophosphatemia, and refeeding syndrome. RESULTS: Three hundred forty-one patients were included (mean age, 61.7 years; mean duration of PN, 8.5 days; central PN, 97%). Metabolic complications occurred more frequently in patients with a baseline CCWCPN than without these conditions (77% vs 53%, P = .001). Subgroup analyses for the development of metabolic complications in patients with or without each individual baseline CCWCPN yielded the following statistically significant results: hypernatremia (93% vs 57%, P = .007) and hyperchloremia (86% vs 57%, P = .033). CONCLUSIONS: Hospitalized adult patients with a baseline CCWCPN were more likely to develop a metabolic complication when receiving PN. Baseline hypernatremia and hyperchloremia were associated with the development of metabolic complications. Baseline CCWCPN should be recognized upon initiation of PN; practitioners should closely monitor patients to minimize subsequent metabolic complications.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Nutrição Parenteral / Doenças Metabólicas Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Nutrição Parenteral / Doenças Metabólicas Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article