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4CPS-229 Pharmaceutical interventions in the management of parenteral nutrition in critically ill patients
  1. M Valera Rubio,
  2. MB Fuentes Ibáñez,
  3. JL Ortiz Latorre,
  4. JM Fernandez Ovies
  1. Hospital Virgen de la Victoria, Hospital Pharmacy, Málaga, Spain


Background Currently, the functions of the clinical pharmacist in relation to parenteral nutrition (PN) are based on the preparation of these formulas and checking that the composition is adapted to the nutritional requirements and the clinical situation of the patient. The pharmacist can collaborate with the intensive care unit (ICU) physicians in the optimisation of nutritional support in critical patients.

Purpose Description and analysis of pharmaceutical interventions (PIs) concerning PN in critical patients and the establishment of the degree of acceptance by physicians who belong to the ICU in a tertiary hospital.

Material and methods A prospective study was conducted (July to September 2017). Variables included: demographics, indication of PN and type of PI. Data were obtained from medical and pharmaceutical nutrition records.

Results Four hundred and fifty-one PN prescriptions were recorded for 33 patients (30% were females; mean age was 61, range 19–70). The average duration of treatment with PN was 18 days (1–44). Seventy-six interventions were recorded (2.3 PIs/patient). 5.3% were made at the beginning of the prescription, 92.1% were follow-up interventions and 2.6% were made at the end of the PN therapy.

Distribution of PIs according to indication: postoperative complications (36.8%); colorectal surgery (18.4%); upper gastrointestinal tract surgery (17.1%); pancreatitis (13.2%); critically ill patients with a contraindication to enteral feeding (13.2%) and liver diseases (1.3%).

Regarding the kind of PI, 7.9% of them were made to recommend stopping PN administration or putting off the end, 59.2% were to propose a change in macronutrient composition according to requirements; 6.6% were adjustment in hours of infusion/day in cholestasis, 7.9% were modifications in the amount of electrolytes administered parenterally, 15.8% were a request for laboratory markers of nutritional status and 2. 6% were about the insulin in the PN monitoring.

86.8% of PIs were accepted by physicians.

Conclusion More than two PIs were performed per patient, mostly during the treatment follow-up and in patients with heterogeneous indications of PN. Most of the PIs were due to the need for adjusting the composition of the macronutrients to the nutritional requirements and the patient’s clinical situation. The acceptance rate of PIs was highly significant, which demonstrates that ICU physicians take into account these recommendations.

No conflict of interest

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