Practice of parenteral nutrition in hospitalized adult patients in Korea: A retrospective multicenter cross-sectional study

Abstract

There have been no studies on the characteristics of parenteral nutrition (PN) supply for adult inpatients in South Korea. The aim of this retrospective multicenter cross sectional study was to investigate the current practice and characteristics of PN support in hospitalized adult patients in South Korea for the first time. This study was conducted retrospectively for the adult patients who were hospitalized and received PN in nine hospitals on August 1st, 2017 to October 30 th , 2017. We evaluated the type of PN formulation, PN administration period, administration route, calories supplied, amount of protein supplied, and laboratory results. Among the 11,580 inpatient admissions on that day, 1,439 patients received PN (12.4%). The majority of enrolled patients (96.5%) used the commercial PN, of which 86.2% were multi-chamber. 71.2% of them received PN peripherally. The average in hospital PN duration was 17.8 ± 52.6 days. Patients received only 65.4 ± 25.4% calories of their target calories. The in-hospital mortality of enrolled patients was 22%. In South Korea, commercial PN was usually administered to hospitalized adult patients and in-hospital mortality in adult patients using PN was higher in South Korea compared to other countries. This study provides the characteristics and the PN support status of hospitalized adult patients receiving PN in South Korea.

Are we underusing peripheral parenteral nutrition? A 5‐year retrospective review of inpatient parenteral nutrition practices

“…Only 18 patients (5.3%) received PPN; one patient with chronic intestinal failure, eight with acute intestinal failure, and nine with non–intestinal failure indications 11 . By contrast a recent retrospective multicenter cross‐sectional study of PN practices within Korean hospitals reported 71.2% of the 1439 patients who received PN during the 3‐month study period received PPN 12 . Although neither study reports the rationale or circumstances under which PPN was used over CPN, taken together with the data presented from our facility, it seems reasonable to assume that the use of PPN appears to be governed by factors specific to the facility rather than patient group per se.…”

“…Where studies do exist, they frequently do not reflect contemporary PN practices, such as the use of shelf‐stable bags, catheter care bundles or management by a multidisciplinary nutrition support team (NST) 6,10 . Moreover, recent studies that report using PPN suggest wide variation internationally in the practices associated with the selection of route for PN delivery 11,12 . Furthermore, international evidence‐based guidelines on the use of PN appear to assume the provision of CPN, and do not make recommendations around clinical circumstances where the use PPN may be preferred over CPN 3,4,13 …”

“…6,10 Moreover, recent studies that report using PPN suggest wide variation internationally in the practices associated with the selection of route for PN delivery. 11,12 Furthermore, international evidence-based guidelines on the use of PN appear to assume the provision of CPN, and do not make recommendations around clinical circumstances where the use PPN may be preferred over CPN. 3,4,13 In our center, CPN has traditionally been the route through which PN is delivered because of the relative ease of obtaining CVAD placements, and because of difficulties accessing compounded PPN solutions.…”

Factors associated with all-cause mortality at 90 days in hospitalized adult patients who received parenteral nutrition

“…The prevalence of PN varies depending on country, methodology and period studied. It ranged from 0.68 % to 0.82 % considering total hospital discharges (1,2), and from 7.9 % to 12 % considering only hospitalized patients at any given time (3,4). In intensive care units (ICU), a worldwide study reported that around 10 % of patients received exclusively PN during 2007-2013 (5).…”