Background A significant proportion of patients are receiving parenteral nutrition (PN) for elective surgery in our abdominal surgery unit.
Purpose To assess compliance of prescriptions with international guidelines.
Material and methods Patients who underwent elective surgery and who received PN were selected during a 6-month period (January 2013–June 2013). The ESPEN guidelines1 were considered the reference guidelines. The clinical pharmacist assessed conformity with guidelines with information from prescriptions and medical files.
Results 23 patients were selected: 15 patients had uncomplicated surgery (US), 6 had postoperative ileus (PI) and 2 another complication (OC). ESPEN guidelines recommend preoperative PN in severely undernourished patients who cannot be adequately orally or enterally fed. Postoperative PN is recommended for undernourished patients in whom enteral nutrition is not feasible or tolerated, or when patients with postoperative complications impairing gastrointestinal functions are unable to meet energy requirements for at least 7 days. Only 6 treatments (26%) complied with the guidelines: As none of the patients qualified as undernourished and all patients had gastrointestinal impairment due to surgery, only patients with PN at least 7 days after surgery complied with guidelines.
Conclusion This study demonstrates most PN treatments in elective abdominal surgery are not in agreement with the guidelines. A multidisciplinary group (nutritionist, dietician, surgeon and pharmacist) was created to implement specific protocols. Measures for improvement will be taken and monitored in 2014.
References and/or Acknowledgements
Braga M, Ljungqvist O, Soeters P, et al. ESPEN guidelines on parenteral nutrition: surgery. Clin Nutr 2009;28:359–472
References and/or AcknowledgementsNo conflict of interest.
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