RESUMO
Introducción La nutrición parenteral (NP) es una parte integral del tratamiento médico de aquellos pacientes que no tienen un tracto gastrointestinal funcionante o accesible. En este trabajo se describen las características clínicas de los pacientes que han recibido NP en un hospital de 420 camas desde 2009 hasta 2011. Además, se evaluaron los parámetros nutricionales al inicio y fin de la NP, y se analizaron las complicaciones asociadas. Material y métodos Estudio observacional retrospectivo de los episodios de NP en mayores de 18 años seguidos por la Unidad de Nutrición del Hospital Universitario de Guadalajara. Se recogieron: datos epidemiológicos y clínicos, número y tipo de vías empleadas, datos antropométricos, datos analíticos, número de días con NP, causa de la retirada, aporte calórico, prevalencia de flebitis, complicaciones metabólicas (hipertrigliceridemia, alteraciones en las pruebas de función hepática, hiperglucemia y síndrome de realimentación) y prevalencia de bacteriemia asociada a catéter venoso central (BAC).Resultados Se registraron 312 episodios de NP. La indicación inmediata fue íleo posquirúrgico en el 53,8% de los episodios. Se produjo una mejoría estadísticamente significativa de todos los parámetros analíticos que se evaluaron (albúmina, prealbúmina, proteína transportadora de retinol, transferrina, colesterol y linfocitos). El aporte calórico (Kcal por kg de peso) fue de 25,1 ± 6,6. En el 16,3% de los episodios no se registró ninguna complicación (..) (AU)
Introduction 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. Material and 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. Discussion 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 (AU)
Assuntos
Humanos , Avaliação Nutricional , Nutrição Parenteral Total/métodos , Distúrbios Nutricionais/dietoterapia , Bacteriemia/complicações , Íleus/dietoterapia , Resultado do Tratamento , Complicações Pós-Operatórias/dietoterapiaRESUMO
INTRODUCTION: 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. MATERIAL AND 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. DISCUSSION: 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.
