Background Although parenteral nutrition (PN) is a lifesaving therapy in undernourished patients, its use may be associated with metabolic complications.
Purpose To analyse the incidence of metabolic complications associated with PN administration in patients admitted to the intensive care unit (ICU).
Material and methods Observational and retrospective study. All patients who received PN in the ICU between January and March 2017 were included. Demographic, clinic and nutrition information were obtained from Diraya® and Kabisoft®.
Demographics, indication, duration, venous access, composition of the nutrition and associated complications were registered.
Hyperglycaemia (>200 mg/dl), hypoglycaemia (<60 mg/dl), electrolytic alterations (EA) (sodium and/or potassium), hypertriglyceridaemia (>250 mg/dl), hypercholesterolaemia (>200 mg/dl), creatinine (>3 mg/dl), urea (>60 mg/dl), metabolic acidosis y cholestasis (alkaline phosphatase (AF) >380 UI/L, and glutamic transaminase (GGT) >50 UI/L of bilirubin >1.2 mg/dl) were the parameters considered metabolic complications. Rate and density of incidence (number of episodes per 100 days of parenteral nutrition in case of the most frequent) were determined.
Results Thirty-six patients were included (52.7% males), the average age was 64.75±10.37 years.
PN indications were: intestinal resection 30.5%, fistula or perforation 11.1%, intestinal obstruction 16.7%, suture dehiscence 13.9%, paralytic ileus 8.3%, ulcerative colitis 5.6% and others 16.7%.
10±10 days was the median duration of the PN and 10±11 days the median of the ICU stay.
Central vias channelled were jugular 50%, subclavian 25% and femoral 13.9%.
All patients had daily analysis of glucaemia, sodium, potassium, urea, creatinine and pH. 33.3% also had cholesterol and triglycerides determination, and 47.2% had FA, GGT and bilirrubina determinations as well.
88.9% of the patients presented metabolic complications associated with the PN: 71% presented more than one complication.
Incidence of complications: EA 63.9% (5.01 per 100 days); hyperglycaemia 52.8% (4.14 per 100 days); hyperuricaemia 33.3% (2.6 per 100 days); hypercreatininaemia 16.7% (1.03 per 100 days); metabolic acidosis 31.3% (1.09 per 100 days). None presented hypercholesterolaemia and six presented hypertriglyceridaemia.
The alterations presented in those patients whose AF, GGT and bilirubin were determined, were 23.5%, 52.9% and 29.4%, respectively.
Conclusion Metabolic complications in patients admitted to the ICU were frequent, underscoring electrolytic alterations and hyperglycaemia. These results were in accord with the consulted bibliography.
No conflict of interest
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