ABSTRACT
Objective To investigate the prevalence of parenteral nutrition related central venous catheter infection in elder patients with malignant tumors,and explore the risk factors. Methods The clinical data of 366 patients with malignant tumors who were managed with parenteral nutrition after operation were retrospectively analysed.The data of age,gender, body weight,diagnosis of primary disease,surgical approach,past history,volume of blood and albumin transfusion and time of fever(body temperature ≥38℃) were collected.Parenteral nutrition related parameters such as time of parenteral nutrition,total calorie,non-protein cMorie,amount of fat,protein and glucose,calorie to nitrogen ratio and carbohydrate to fat ratio were also recorded. Results The mean age of 366 patients was (71.8±6.9)years,mean time of parenteralnutrition was (10.6±6.3)d,and total time of catheterization was 3 336 days.The prevalence of parenteral nutrition related central venous catheter infection was 2.5%(9/366).Logistic regression analysis demonstrated that the relative risks of plasma albumin level before parenteral nutrition and time of high fever to catheter infection were 1.257 and 2.518,respectively(P<0.01 for both). Conclusion Plasma albumin level before parenteral nutrition and time of fever were two risk factors for parenteral nutrition related catheter infection in elder patients with malignant tumors.
ABSTRACT
Objective To evaluate the effects of lipid emulsion on parenteral nutrition associated liver dis ease (PNALD) in old tumor patients. Methods A retrospective study was performed with 402 patients in Renji Hospital from January 2003 to December 2008. Patients were retrieved according to the following criteria: (1)age ≥60 years; (2) confirmed diagnosis of tumor, had no evidence of metastasis, and tumor was completely resected before receiving parenteral nutrition; (3) liver and kidney function was in normal range before receiving parenteral nutrition; (4) parenteral nutrition days ≥7; and (5) parenteral nutrition was infused in "all in one" bag via central venous. Patients with history of viral hepatitis or died in parenteral nutrition episode were excluded. These 402 patients aged (71.7 ±6.8) years and the average parenteral nutrition time was (10. 2 ±5.9) (range, 7-61 )days. In 311 patients (77.4％), non-protein calorie was obtained from carbohydrate and lipid and 91 patients (22. 6％ ) just obtained non-protein calorie from carbohydrate. Results The total prevalence of PNALD was 15.2％ (61/402). The prevalence of PNALD was 8.8％ (8/91) in patients receiving parenteral regiment without lipid and 17.0％ (53/311) in patients receiving parenteral nutrition with lipid, and there was no significant difference in prevalence of PNALD between two groups (χ2 = 3.72, P = 0.07 ). Lipid type and amount showed no significant effects on PNALD ( P ＞ 0.05 ). The fever days ( P ＜ 0. 001 ), baseline level of alanine transaminase (P ＜0. 001 ) and γ-glutamyltransferase (P ＜0. 001 ) were risk factors for liver injury by logistic regression. Conclusion Lipid emulsion can be safely used in old tumor patients without affecting the occurrence of PNALD.