Osteomyelitis in adult patients on long-term parenteral nutrition: 2745 patient-years of experience in a national referral centre

Allan, Philip; Stevens, Philip; Chadwick, Paul; Teubner, Antje; Abraham, Arun; Carlson, Gordon L; Lal, Simon

doi:10.1016/j.clnu.2015.09.002

Cited by 8 publications

(3 citation statements)

References 19 publications

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“…Hepatobiliary system abnormalities in patients requiring long‐term PN are commonly reported and can be life‐threatening. The prevalence of mild liver dysfunction presenting as abnormal liver‐enzyme elevation varied from 25% to 100% in adult patients receiving long‐term home PN 7‐10 . In this study, liver dysfunction was a common finding, but the incidence of liver dysfunction (36%) tended to be lower than those reported in the past.…”

Section: Discussioncontrasting

confidence: 49%

“…The prevalence of mild liver dysfunction presenting as abnormal liver-enzyme elevation varied from 25% to 100% in adult patients receiving long-term home PN. [7][8][9][10] In this study, liver dysfunction was a common finding, but the incidence of liver dysfunction (36%) tended to be lower than those reported in the past. The reason for the relatively small number of patients with liver dysfunction in this study may be related to our practice of close monitoring of adverse reactions during the time these patients were receiving PN in the hospital.…”

Section: Discussionmentioning

confidence: 49%

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Parenteral Nutrition–Associated Liver Disease in Adult Inpatients Receiving Commercial Premixed Parenteral Nutrition for More Than 2 Weeks

Park

Lee

Jung

et al. 2020

J Parenter Enteral Nutr

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Background Long‐term use of parenteral nutrition (PN) may elicit complications, including PN‐associated liver disease (PNALD), which may yield critical outcomes. This study intended to investigate the development of complications associated with commercial premixed PN in adult patients. Methods Adult patients who received nutrition support with commercial PN without enteral intake for >14 consecutive admission days were included in the analysis. Results Seventy‐two adults, from 2001 to 2016, were reviewed. Mean length of hospital stay was 43.0 days. A mean of 27.3 days of PN was given. Mean energy supplied by PN was 29 kcal/kg/d. Ten patients (13.8%) developed PNALD. Length of stay was significantly longer (P = .034), and duration of PN administration was significantly longer (P = .022) in patients who developed PNALD. The proportion of PN products with soybean oil–based lipids was significantly higher, and fish oil– or medium‐chain triglyceride–containing combination lipids were significantly lower in the patient group with PNALD (P = .02). Multivariate logistic regression analysis showed that longer duration of days receiving PN support was an independent risk factor for PNALD (odds ratio, 1.052; P = .029). Conclusion : The incidence of PNALD in hospitalized adult patients who received daily PN support with commercial premixed 3‐in‐1 products for >2 weeks was 13.8%. Longer duration of days receiving PN support was an independent risk factor for PNALD.

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 49%

Parenteral Nutrition–Associated Liver Disease in Adult Inpatients Receiving Commercial Premixed Parenteral Nutrition for More Than 2 Weeks

Park

Lee

Jung

et al. 2020

J Parenter Enteral Nutr

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“…CLABSIs were diagnosed using a standardized approach, recommended in IDSA guidelines, using paired blood culture samples taken peripherally and centrally, including pour plates, allowing quantitative and qualitative analysis 18 . For a CLABSI to have been associated with IE, it had to have occurred within the year preceding the diagnosis, as per previous studies on the complications of CLABSI in the IF population 19 …”

Section: Methodsmentioning

confidence: 99%

Infective Endocarditis in Patients With Intestinal Failure: Experience From a National Referral Center

Sawbridge

Taylor

Teubner

et al. 2020

J Parenter Enteral Nutr

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Background Infective endocarditis (IE) is a recognized complication of central line–associated bloodstream infection (CLABSI). Central venous access devices (CVADs) are essential for the delivery of long‐term parenteral nutrition (PN), yet there are no published data as to the prevalence, characteristics and outcomes of IE in this population. Methods A prospectively maintained database of patients with intestinal failure (IF) types 2 and 3, managed by a national intestinal failure center between January 2010 and December 2018, was analyzed retrospectively and relevant factors extracted from case records. Results A total of 745 patients with IF and CVADs in situ on admission, or placed during their stay, were admitted over the duration of this study, 640 with type 2 IF and 105 with type 3 IF. Two hundred eighty‐two echocardiograms were performed to investigate potential IE associated with a CLABSI event. Four cases of IE were identified in the entire cohort of 782,666 catheter days (IE incidence rate: 0.005 per 1000 catheter days and 187 per 100,000 person‐years for the entire cohort; 0.048 per 1000 inpatient catheter days for acute type 2 IF, 0.0026 per 1000 outpatient catheter days [ie, 99 per 100,000 person‐years for outpatients with type 3 IF]). Conclusion IE is rare in the type 3 IF population and a rare consequence of CLABSI in inpatient acute type 2 IF. However, mortality and morbidity are high. Routine echocardiography may not be warranted for investigation of CLABSI unless there is a high risk of IE or a virulent organism is involved.

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Catheter-related bloodstream infection management in patients receiving home parenteral nutrition: An observational cohort study

Gompelman

Causevic

Bleeker‐Rovers³

et al. 2022

Clinical Nutrition ESPEN

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Osteomyelitis in adult patients on long-term parenteral nutrition: 2745 patient-years of experience in a national referral centre

Cited by 8 publications

References 19 publications

Parenteral Nutrition–Associated Liver Disease in Adult Inpatients Receiving Commercial Premixed Parenteral Nutrition for More Than 2 Weeks

Parenteral Nutrition–Associated Liver Disease in Adult Inpatients Receiving Commercial Premixed Parenteral Nutrition for More Than 2 Weeks

Infective Endocarditis in Patients With Intestinal Failure: Experience From a National Referral Center

Catheter-related bloodstream infection management in patients receiving home parenteral nutrition: An observational cohort study

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