title: [Nutritional support with parenteral nutrition. Course and associated complications].
abstract: BACKGROUND
  Parenteral nutrition (PN) is an integral part of medical management of patients who do not have a functioning or accessible gastrointestinal tract. This paper discusses the clinical characteristics of patients receiving PN in a 420-bed hospital from 2009 to 2011. In addition, nutritional parameters were assessed at the start and end of PN and associated complications were analyzed.
  
  
  METHODS
  retrospective, observational study of PN episodes in adults conducted at the Nutrition Unit of Hospital Universitario de Guadalajara. Variables collected included epidemiological and clinical data, number and type of routes used, anthropometric data, analytical data, number of days on PN, reason for withdrawal, caloric provision, prevalence of phlebitis, metabolic complications (hypertriglyceridemia, abnormal liver function tests, hyperglycemia, and refeeding syndrome), and prevalence of bacteremia associated with central venous catheter (BAC).
  
  
  RESULTS
  There were 312 episodes of PN. The immediate indication was postoperative ileus in 53.8% of the episodes. There was a statistically significant improvement in all analytical parameters assessed (albumin, prealbumin, retinol binding protein, transferrin, cholesterol, and lymphocytes). Caloric provision (kcal per kg) was 25.1±6.6. No metabolic complication occurred in 16.3% of the episodes, and hyperglycemia was the most common complication (79.8%). There were 10 cases of phlebitis (32.2%) and 30 episodes of BAC (8.7%). Bacteriemia rate was 8.1 per 1000 days of PN.
  
  
  CONCLUSIONS
  Although PN is an effective nutritional support technique, it is associated with complications of varying severity. Use of PN should therefore comply with the instructions accepted in the main clinical practice guidelines and requires careful monitoring by experienced professionals.
authors.affiliation: Sección de Endocrinología y Nutrición, Hospital Universitario de Guadalajara, Guadalajara, España. herranzantolin@yahoo.es
authors.forename: Sandra
authors.initials: S
authors.lastname: Herranz Antolín
authors.forename: Visitación
authors.initials: V
authors.lastname: Álvarez De Frutos
authors.forename: Marta
authors.initials: M
authors.lastname: Blasco Guerrero
authors.forename: Maria del Carmen
authors.initials: Mdel C
authors.lastname: García Martínez
authors.forename: Maria del Carmen
authors.initials: Mdel C
authors.lastname: Gimeno Fernández
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D018529:Nutritional Support; D010288:Parenteral Nutrition / Q000009:adverse effects; D012189:Retrospective Studies