Nutrition parenteral nutrition March 18, 2022

Compared with oral or low-calorie nutrition, the use of Parenteral nutrition was not associated with increased mortality, overall frequency of complications, or longer hospital stay (LOS). The risk of PN complications (eg, feeding syndrome, hyperglycemia, bone demineralization, catheter infection) can be minimized by carefully monitoring the patient and using a nutritional support team, especially especially in the long term PN.

Parenteral nutrition (PN) is beneficial and life-saving in a variety of medical conditions, but can also cause a variety of potentially serious side effects. The risk of such complications can be minimized by careful patient monitoring and the involvement of nutritional support teams.

The benefits and side effects of Parenteral Nutrition have been the subject of extensive literature reviews and in-depth scientific discussions. Persistent hyperglycemia and associated immunosuppression are considered causal factors for poor patient outcomes.

Complications and its management

Complications associated with PN can be classified as compression-related, conduction-related, and metabolic complications.

Catheterization complications
Pneumothorax -This is the most common intubation complication, with an incidence of 0.5 to 1% and it occurs mainly during subcutaneous catheterization, but can also happens for the inner pipe approach. If there are symptoms (difficulty breathing or severe pain), a chest tube should be placed and then removed immediately.

A displaced thoracic radiograph is required after subcutaneous cvc and thoracic tube insertion to verify correct tip position (in the lower third of the superior vena cava or at the vena cava junction) and identify the pneumothorax or possible site (ie, in the pleural space or in another vessel).

Gland complications

Sepsis, also known as CRBSI (catheter-associated blood infection) is a serious complication, with significant morbidity and mortality. Hospitals track and report sepsis online as a quality indicator. Microbiology will give appropriate advice on antibiotic treatment. If a fungal infection occurs, the line should be removed, except in exceptional cases.

Acute complications

Electrolyte disturbances need to be identified and corrected; These diseases are more common in early PN, so close follow-up is necessary to identify them before clinical symptoms appear.
Refeeding syndrome– This may be a complication of life for life in the first days after starting food in patients with serious malnutrition.

 Sepsis is usually a precipitate, whether intra-abdominal, due to the grace of the line or another source. Antibiotics used to treat sepsis can contribute. Hepatitis and can be present like this due to excess alcohol, autoimmune disease or gallstones.

Chronic Complications

Complications associated with long-term PN are less well understood and more difficult to treat. Liver disease The incidence of liver disease in long-term FSWs varies from report to report. At least 25% of home PN patients have cholestatic liver function tests.

In a much lower percentage, the disease progresses to fibrosis and then cirrhosis. NASH is a serious complication known as infectious hepatitis, which involves bacterial overgrowth and intestinal translocation of bacteria into the portal circulation.

Maintenance of physiological bone metabolism requires adequate serum concentrations of vitamin D, calcium, magnesium and phosphate. In patients with long-term PN, serious disorders leading to osteoporosis and fractures can occur. administration of injections