Systematic review and meta-analyses of the effect of lipid emulsion on microbial growth in parenteral nutrition

Austin, P.; Hand, Kieran; Elia, Marinos

doi:10.1016/j.jhin.2016.08.026

Cited by 15 publications

(16 citation statements)

References 34 publications

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“…Commentary PN is considered as a medium where several factors may influence microbial growth leading to CRBSI risk [108]. In a prospective, randomized study, an intention-to-treat analysis demonstrated a higher level of intravenous tubing (administration set) colonization in tubes changed every 4-to 7-days vs. those only changed every 3-days; however, the two groups had a comparable rate of colonization when patients receiving PN (n ¼ 84) were excluded from this study [109].…”

Section: Recommendation 22mentioning

confidence: 99%

ESPEN guideline on home parenteral nutrition

et al. 2020

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This guideline will inform physicians, nurses, dieticians, pharmacists, caregivers and other home parenteral nutrition (HPN) providers, as well as healthcare administrators and policy makers, about appropriate and safe HPN provision. This guideline will also inform patients requiring HPN. The guideline is based on previous published guidelines and provides an update of current evidence and expert opinion; it consists of 71 recommendations that address the indications for HPN, central venous access device (CVAD) and infusion pump, infusion line and CVAD site care, nutritional admixtures, program monitoring and management. Meta-analyses, systematic reviews and single clinical trials based on clinical questions were searched according to the PICO format. The evidence was evaluated and used to develop clinical recommendations implementing Scottish Intercollegiate Guidelines Network methodology. The guideline was commissioned and financially supported by ESPEN and members of the guideline group were selected by ESPEN.

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Section: Recommendation 22mentioning

confidence: 99%

ESPEN guideline on home parenteral nutrition

et al. 2020

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“…IVS overfeeding and a high amount of lipid emulsion are recognised causes of IFALD 2 10. Similarly, CRBSI occurrence has also previously been reported to occur more frequently in those dependent on an increased number of days of IVS8; this may relate to more frequent handling of the central venous catheter, increasing infection risk or the association between macronutrients, vitamins and trace metals affecting microbial growth in the PN admixture 11 12…”

Section: Discussionmentioning

confidence: 94%

Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure

Pironi

Steiger

Joly

et al. 2020

Gut

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Background and aimNo marker to categorise the severity of chronic intestinal failure (CIF) has been developed. A 1-year international survey was carried out to investigate whether the European Society for Clinical Nutrition and Metabolism clinical classification of CIF, based on the type and volume of the intravenous supplementation (IVS), could be an indicator of CIF severity.MethodsAt baseline, participating home parenteral nutrition (HPN) centres enrolled all adults with ongoing CIF due to non-malignant disease; demographic data, body mass index, CIF mechanism, underlying disease, HPN duration and IVS category were recorded for each patient. The type of IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorised as <1, 1–2, 2–3 and >3 L/day. The severity of CIF was determined by patient outcome (still on HPN, weaned from HPN, deceased) and the occurrence of major HPN/CIF-related complications: intestinal failure-associated liver disease (IFALD), catheter-related venous thrombosis and catheter-related bloodstream infection (CRBSI).ResultsFifty-one HPN centres included 2194 patients. The analysis showed that both IVS type and volume were independently associated with the odds of weaning from HPN (significantly higher for PN <1 L/day than for FE and all PN >1 L/day), patients’ death (lower for FE, p=0.079), presence of IFALD cholestasis/liver failure and occurrence of CRBSI (significantly higher for PN 2–3 and PN >3 L/day).ConclusionsThe type and volume of IVS required by patients with CIF could be indicators to categorise the severity of CIF in both clinical practice and research protocols.

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“…Additional specific RNA detection using RT‐PCR or RNASeq approaches should be considered. Beyond BCs, the impact of the composition of a health care product on bacterial growth was further studied on lipid emulsions in parenteral nutrition . Because of the central role of citrate in the selection of virulent strains, alternative anticoagulant and conservation solutions could be tested.…”

Section: Discussionmentioning

confidence: 99%

“…Beyond BCs, the impact of the composition of a health care product on bacterial growth was further studied on lipid emulsions in parenteral nutrition. 45 Because of the central role of citrate in the selection of virulent strains, alternative anticoagulant and conservation solutions could be tested. Nevertheless, the consequences on the growth of the other bacterial species must be carefully monitored.…”

Section: Discussionmentioning

confidence: 99%