How appropriate are the indications for parenteral nutrition patients? Parenteral beslenen hastaların endikasyonları ne kadar uygun?
Anestezi Dergisi, cilt.28, sa.2, ss.116-123, 2020 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 28 Sayı: 2
- Basım Tarihi: 2020
- Doi Numarası: 10.5222/jarss.2020.52724
- Dergi Adı: Anestezi Dergisi
- Derginin Tarandığı İndeksler: Scopus, Academic Search Premier, Central & Eastern European Academic Source (CEEAS), EMBASE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.116-123
- Anahtar Kelimeler: Calorie, Indication, Nutrition support team, Parenteral nutrition
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Parenteral nutrition (PN) is a treatment method that provides intravenous nutrition. PN may improve clinical outcomes and may lead to an increase in mortality and morbidity due to complications. The aim of this study was to evaluate the indications of PN, to determine the incidence of inappropriate initiation of PN, and to investigate caloric adequacy. Method: All patients who started to receive PN were identified from the hospital database and visited by the nutrition nurse and dietician. Demographic data, service, diagnosis, PN compliance, indications, calorie intake and adequacy of the patients were evaluated. Each patient receiving PN was examined according to the guidelines of the European Association of Clinical Nutrition and Metabolism (ESPEN) and classified as “appropriate” and “inappropriate”. In addition, patients receiving PN were divided into 4 categories as Peripheral PN, Central PN, Enteral+PN, Oral+PN. Results: In our hospital, 333 patients underwent PN for six months. PN was started due to vomiting preventing oral intake (37%), obstructive bowel disease (27%), severe diarrhea (12%) and severe malabsorption (12%). In 153 (45.9%) patients PN were started with inappropriate indication. The most frequent reasons for inappropriate indication were the preference of the doctor for conservative PN (142 cases, 92.8%). While 256 (76.9%) of the patients who started PN were receiving inadequate calorie intake. Peripheral parenteral nutrition (PPN) (155 cases, 46.5%) was most frequently preferred in the nutrition of the patients, inappropriate indication for PN (40%) and inadequate calorie intake (98.1%) were seen in this group. Conclusion: In patients who cannot receive adequate oral or enteral nutrition for any reason, PN is initiated alone or in addition to enteral nutrition. In order to minimize the risks associated with PN, PN indications should be well known and nutrition-oriented training should be planned. We believe that the recommendations of the hospital nutritional support team (NDE) should be taken into consideration against the risk of inappropriate indication and insufficient calorie administration.