title: Parenteral nutrition mixtures prepared at home by trained parents are as safe as pharmacy-made mixtures: a 3-y prospective study.
abstract: OBJECTIVE
  Home parenteral nutrition (HPN) prevents malnutrition in children with intestinal failure improving chances for the best possible physical development and quality of life. For organizational reasons, in Poland the majority of children on HPN receive nutrition mixtures prepared at home by their parents. The aim of this study was to evaluate whether this method influences the frequency of catheter-related bloodstream infections (CRBSIs).
  
  
  METHODS
  The aim of this prospective study was to assess the incidence of CRBSIs from January 2008 to December 2010 in 181 children on HPN and to compare the incidence in two subgroups of these children: group Ph (pharmacy) consisting of 43 patients receiving mixtures prepared in the hospital pharmacy weekly, and group H (home)-138 patients receiving nutrition mixtures prepared daily at home by their caregivers. Central venous CRBSIs were diagnosed by the presence of clinical signs (such as fever, chills, malaise, vomiting) associated with positive blood culture from the central catheter.
  
  
  RESULTS
  From 2008 to 2010 parenteral nutrition was administrated during 128 905 catheter-days in 181 patients, and CRBSIs occurred 129 times (1 episode per 1000 catheter-days) in 65 patients. There were 42 bloodstream infections in group Ph during 29 225 catheter-days (i.e., 1.43 per 1000 catheter-days), whereas 87 bloodstream infections occurred in group H during 100 775 catheter-days (i.e., 0.86 per 1000 catheter-days; P = 0.0516).
  
  
  CONCLUSIONS
  Preparing parenteral nutrition mixtures at home by trained parents is a safe method of HPN with a slightly (however insignificantly) lower incidence of CRBSIs compared with hospital pharmacy-prepared parenteral nutrition mixtures.
authors: Department of Pediatrics and Nutrition, Children's Memorial Health Institute, Warsaw, Poland. joanna@friedman.pl
authors: Joanna
authors: J
authors: Friedman-Gruszczyńska
authors: Magdalena
authors: M
authors: Ossolińska
authors: Katarzyna
authors: K
authors: Popińska
authors: Janusz B
authors: JB
authors: Książyk
mesh_terms: D000293:Adolescent; D000328:Adult; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects; D057785:Catheters / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D044342:Malnutrition / Q000517:prevention & control; D009753:Nutritive Value; D057947:Parenteral Nutrition Solutions / Q000009:adverse effects*; D016331:Parenteral Nutrition, Home / Q000009:adverse effects*; D010290:Parents / Q000193:education*; D011044:Poland; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D055815:Young Adult
chemical_list: D057947:Parenteral Nutrition Solutions