Parenteral nutrition with standard solutions: not the best solution for everyone? A retrospective audit of 300 patients.
An observational retrospective study audited the incidence of adverse events in 300 consecutive inpatients receiving a single, premade total nutrient admixture. No patient experienced critically high triglycerides; 16% of patients had a metabolic adverse event, including raised bilirubin, urea, creatinine, or liver enzymes. Line sepsis occurred on 30 occasions representing 0.67 infections per 1000 catheter days. Mortality was significantly higher in dialysis, nonsurgical, and intensive care unit patients. The use of a standard formulation for all parenterally nourished patients does not lead to an unacceptable incidence or severity of metabolic complications; however, it did not meet the protein requirements of surgical or critically ill patients.
Royal Prince Alfred Hospital, Sydney, Australia (Mss Ferrie, Carey, Ryan, Jones, and Segaert; Drs Storey and Sandroussi); and University of Sydney, Sydney, Australia (Mss Ferrie and Carey). Suzie Ferrie, MNutrDiet, AdvAPD (Australia), CNSC, has been the critical care dietitian in the intensive care unit at Sydney's Royal Prince Alfred Hospital since 2001. She is also the national convenor of the nutrition support interest group of the Dietitians' Association of Australia. Sharon Carey, MNutrDiet, APD, is the deputy manager in the Department of Nutrition and Dietetics at Royal Prince Alfred Hospital, the senior dietitian in the upper gastrointestinal unit, and a consultant to the hospital's intestinal failure clinic. She was awarded a Churchill Fellowship to conduct an international study of dietetic management of intestinal failure. Rachelle Ryan, MNutrDiet, APD, is the clinical educator in the Department of Nutrition and Dietetics at Royal Prince Alfred Hospital and a dietitian in the upper gastrointestinal unit. Charbel Sandroussi, MBBS(Hons), MMSc, FRACS, is a surgeon in the Royal Prince Alfred Hospital's Department of Gastrointestinal and Liver Services. He also heads the hospital's parenteral nutrition service. Lynn Jones, MNNP, MPH, BHSc, is a nurse practitioner in parenteral nutrition at Royal Prince Alfred Hospital, where she oversees the management of parenteral nutrition for inpatients, as well the hospital's home parenteral nutrition and intestinal failure service. David Storey, MBBS, FRACS, is the head of upper gastrointestinal surgery at Royal Prince Alfred Hospital. Retired from his leadership role in the hospital's parenteral nutrition service, he continues to provide consultation and support. Nicole Segaert, BPharm, DipHospPharm, is the pharmacist for the parenteral nutrition service at Royal Prince Alfred Hospital.
Suzie
S
Ferrie
Sharon
S
Carey
Rachelle
R
Ryan
Charbel
C
Sandroussi
Lynn
L
Jones
David
D
Storey
Nicole
N
Segaert
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D012189:Retrospective Studies