Multicenter Study of Parenteral Nutrition in Non-Critically Ill Elderly Patients Compared to Younger Patients - Study IAIOS-PN (Incidence and Assessment of Iatrogenesis in Older Subjects receiving Parenteral Nutrition)

Antonio, Javier; Berlana, David; Pons‐Bussom, Montserrat; Badia-Tahull, M.B.; Miana‐Mena, María Teresa; Martínez-Castro, Beatriz; Sunyer‐Esquerrà, Neus; Sanmartin-Suñer, Mónica; González‐Valdivieso, Juan; Leiva‐Badosa, Elisabet; Martínez‐Bernabé, Eva; Murgadella‐Sancho, Anna; Mirerachs‐Aranda, Nuria; Vila-Bundo, Anna; Fernández-Morató, Jordi; Vitales‐Farrero, María Teresa

doi:10.20960/nh.1393

Cited by 2 publications

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“…Patients who had been entered in the IAIOS‐PN study 4 were eligible for inclusion in this study, which assessed the incidence of hyperglycemia, hypertriglyceridemia, and LFT alterations in adult patients receiving PN. They were followed‐up until PN was discontinued, oral or enteral nutrition was started, or they were admitted to the intensive care unit (ICU) for longer than 3 days or were transferred to another hospital.…”

Section: Methodsmentioning

confidence: 99%

“…In hospitalized patients receiving short‐term PN, it has been set between 4.9% 1 and 57% 2 in general and at 30% in critically ill patients 3 . We found a prevalence of 70% in non–critically‐ill inpatients with an alteration of twice the upper limit of the normal range (ULN) with any liver function test (LFT) 4 …”

Section: Introductionmentioning

confidence: 99%

“…3 We found a prevalence of 70% in non-critically-ill inpatients with an alteration of twice the upper limit of the normal range (ULN) with any liver function test (LFT). 4 Causes of liver alterations in patients receiving PN are multifactorial. Several mechanisms seem to play a role in this adverse effect.…”

Section: Introductionmentioning

confidence: 99%

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Cohort Multicenter Study on the Role of Medications in Parenteral Nutrition–Related Alteration of Liver Function Tests in Adults

Antonio

Miana‐Mena

Martínez‐Bernabé³

et al. 2020

J Parenter Enteral Nutr

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Background Our objective was to assess in non–critically‐ill adult inpatients receiving parenteral nutrition (PN) the risk of developing liver function test (LFT) alterations when receiving concomitant possibly hepatotoxic medications or others reported to improve LFTs during PN. Methods A multicenter retrospective analysis of prospectively collected data was performed on patients receiving PN. Two groups were recruited: group LALT (patients with any LFT alterations during PN), and group NOLALT (patients without such alterations). Exclusion criteria were previous sepsis, shock, renal failure, hyperglycemia, LFT alteration, or biliopancreatic surgical procedures. Medications were classified into 2 categories: medications reported to improve LFTs during PN (n = 8) and possibly hepatotoxic medications (n = 54), including a subgroup of possibly highly hepatotoxic medications (n = 30). Results The study included 200 patients, 136 (68.0%) in the LALT group. The groups differed in the number of patients requiring surgical intervention ≤7 days before PN (LALT, 94 [69.1%]; NOLALT, 29 [45.3%]; P < .002) and those receiving possibly hepatotoxic medications (LALT, 126 [92.6%]; NOLALT, 45 [70.3%]; P < .001). Variables in the final Cox regression model were possibly hepatotoxic medications, odds ratio (OR) 3.310 (1.678–6.530); surgical intervention prior to PN, OR 1.861 (1.277–2.711); baseline triglyceridemia, OR 1.005 (1.001–1.009); and creatinine, OR 1.861 (1.043–3.323). Conclusions Patients who received PN and concomitantly possibly hepatotoxic medications had a 3‐fold risk of developing LFT alterations. Medications reported to improve LFTs had no effect. The use of possibly hepatotoxic medications during PN was associated with LFT alterations.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cohort Multicenter Study on the Role of Medications in Parenteral Nutrition–Related Alteration of Liver Function Tests in Adults

Antonio

Miana‐Mena

Martínez‐Bernabé³

et al. 2020

J Parenter Enteral Nutr

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“…solutions to meet their age-specific high metabolic demands. In adults, iatrogenic hyperglycemia caused by parenteral nutrition has been studied in the context of age-related differences, but except for two case reports there are no systematic studies or case series on ISH in pediatrics [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic severe hyperglycemia due to parenteral administration of glucose in children – a case series

et al. 2020

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Background Iatrogenic severe hyperglycemia (ISH) caused by glucose-containing i.v. solution is a potentially fatal treatment error. The objective of this study was to investigate the causes, circumstances, course of disease, and complications of ISH > 300 mg/dl (16.7 mmol/l) in neonates and children. Methods We emailed a survey to 105 neonatal and pediatric intensive care units in Germany, Austria, and Switzerland, asking to retrospectively report cases of ISH. Results We received 11 reports about premature infants to children. Four patients (36%) had poor outcome: 2 died and 2 suffered persistent sequelae. The highest observed blood glucose was at median 983 mg/dl (54.6 mmol/l) (range 594–2240 mg/dl; 33.0–124.3 mmol/l) and median time to normoglycemia was 7 h (range 2–23). Blood glucose was higher and time to normoglycemia longer in patients with poor outcome. Invasive therapy was required in 73% (mechanical ventilation) and 50% (vasopressor therapy) of patients, respectively. Administration of insulin did not differ between outcome groups. Patients with poor outcome showed coma (100% vs. 40%) and seizures (75% vs. 29%) more frequently than those with good outcome. Conclusions ISH is a severe condition with high morbidity and mortality. Further research to amplify the understanding of this condition is needed, but focus should largely be held on its prevention.

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Multicenter Study of Parenteral Nutrition in Non-Critically Ill Elderly Patients Compared to Younger Patients - Study IAIOS-PN (Incidence and Assessment of Iatrogenesis in Older Subjects receiving Parenteral Nutrition)

Abstract: patients of ≥ 65 years receiving PN had similar incidences of hyperglycemia, hypertriglyceridemia, and LFT alterations as younger patients. Additionally, older patients had trends toward lower LFT alterations.

Cited by 2 publications

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Cohort Multicenter Study on the Role of Medications in Parenteral Nutrition–Related Alteration of Liver Function Tests in Adults

Cohort Multicenter Study on the Role of Medications in Parenteral Nutrition–Related Alteration of Liver Function Tests in Adults

Iatrogenic severe hyperglycemia due to parenteral administration of glucose in children – a case series

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