Assessing the appropriateness of parenteral nutrition use in hospitalized patients. A comparison on parenteral nutrition bag prescription in different wards and nutritional outcomes.

PURPOSE: Our aim is to assess parenteral nutrition (PN) bag prescription in hospitalized patients and evaluate clinical outcomes linked to PN therapy. METHODS: We performed an observational longitudinal retrospective study on PN prescription in a General Public Hospital in Turin, Italy, on ninety-five patients receiving PN prescribed by the Nutrition Support Team (NST). We described patients' demography and assessed nutritional outcomes, as well as PN bag prescription in different wards. Medians were calculated for several clinical parameters before and after PN therapy. A z-test for proportions has been performed to better understand the impact of various conditions on clinical outcomes and to compare differences between administered nutrients and required amounts. RESULTS: The NST resulted responsible for only 18% of bags prescribed in the geriatrics ward and for 48% in the surgery wards. PN was not able to fulfill nutritional requirements resulting in a median lack of 3.1 calories and 0.23 g of proteins per kilogram of reference body weight per day. Despite this, PN therapy was able to improve total blood proteins and calcium blood levels in our cohort. The NST changed the prescription in 55.8% of the pre-existing PN regimens. CONCLUSIONS: More strict adherence to guidelines is needed in order to maximize effectiveness of PN and observe a positive impact on clinical parameters.

[Low protein dinner: patients in the kitchen]. / Cena ipoproteica: i pazienti cucinano.

INTRODUCTION: Diet therapy is important in renal failure to slow down the progression of the nephropathy and to control uremic symptoms. The main barrier is long-term poor compliance because of flavour and appetizing of a low protein meal. METHODS: We organized an educational cooking event in a kitchen laboratory with a chef.Fifty patients came accompanied by their care-giver. They could listen to the chefs advices, observe the manipulation of food, taste the dishes prepared with low protein products and directly cook with the assistance of the chef. The menu consisted of appetizers, two different kinds of pasta dishes, a vegetable dish, olive bread and a dessert.The patients collaborated to prepare bread and pasta. CONCLUSIONS: Patients appreciated the event and participated in an active way. They showed how important is their direct participation in the control of the disease.