Do Patients With a Baseline Clinical Condition Warranting the Cautious Use of Parenteral Nutrition Develop Subsequent Metabolic Complications?
| Autor: | Diana M. Solomon, James M. Hollands, Laura A. Siemianowski, Angela L. Bingham, Richard J. Song, Colleen E. Smith |
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| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine Parenteral Nutrition medicine.medical_specialty Pediatrics Hypochloremia Medicine (miscellaneous) 030209 endocrinology & metabolism Acid-Base Imbalance Refeeding syndrome Hypoglycemia 03 medical and health sciences 0302 clinical medicine Hyperchloremia Metabolic Diseases medicine Humans Intensive care medicine Aged Retrospective Studies Aged 80 and over Hypernatremia 030109 nutrition & dietetics Nutrition and Dietetics business.industry Retrospective cohort study Middle Aged medicine.disease Hypokalemia Hospitalization Parenteral nutrition Female medicine.symptom business |
| Zdroj: | Nutrition in Clinical Practice. 32:400-406 |
| ISSN: | 1941-2452 0884-5336 |
| DOI: | 10.1177/0884533616680793 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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