Cardiac Changes in Patients on Long-Term Parenteral Nutrition

Abstract

Patients with short bowel syndrome (SBS) on long-term home parenteral nutrition (HPN) chronically receive high fluid volumes directly into the right atrium (RA) through the superior vena cava. We retrospectively evaluated cardiac function measured by routine transthoracic echocardiography (TTE) in a population of 26 SBS patients on long-term HPN and compared their data on echocardiograph-derived right heart structure and function, with those of a control group of 26 patients also bearing a central venous catheter (CVC) for other reasons. Results showed that body weight and BMI were significantly higher in the control group. The echocardiographic estimate of RA pressure was higher in HPN patients than in controls (p = 0.01). An increased estimate of RA pressure indicates the need to consider TTE in the follow-up of long-term HPN patients to detect functional impairment early.

Different cardiovascular risk scores in adults receiving long-term home parenteral nutrition

“…In the present study, we found SBP was lower in HPN patients compared to healthy volunteers. PN formula contains lipids, which could potentially explain the reduced blood pressure [11,12]. Furthermore, the reduced SBP in HPN patients could also affect SCORE and PCE results.…”

Haematogenous pneumonia caused by Kocuria kristinae in a patient with a central venous catheter

“…Furthermore, the infection spared the heart valves, causing pulmonary involvement [5] . This means that physicians should not overlook the importance of K. kristinae infection and in case of CVC infection, in addition to the risk of right endocarditis, haematogenous pneumonia must be considered [5,6] . Moreover, the radiological aspect of these excavated nodules required a differential diagnosis with mycotic infections, not neglecting the hypothesis of possible neoplastic metastases [7] .…”