Use of parenteral nutrition in European hospital wards is stable over time but differs across countries: a nutritionday analysis 2006-2019

2021 ◽  
Vol 46 ◽  
pp. S617
Author(s):  
S. Tarantino ◽  
I. Sulz ◽  
U. Mellino ◽  
P. Garcia Lorda ◽  
M. Hiesmayr
Keyword(s):  
Parenteral Nutrition ◽  
Hospital Wards ◽  
Over Time

scholarly journals Incidence of nutritional support complications in patient hospitalized in wards. multicentric study

2012 ◽  
pp. 147-153 ◽  
Author(s):  
Gloria María Agudelo Ochoa ◽  
Nubia Amparo Giraldo Giraldo ◽  
Nora Luz Aguilar ◽  
Beatriz Elena Restrepo ◽  
Marcela Vanegas ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
General Hospital ◽  
Medical Diagnosis ◽  
Nutritional Support ◽  
Nutritional Condition ◽  
High Complexity ◽  
Multicentric Study ◽  
Significant Difference ◽  
Hospital Wards

Introduction: Nutritional support generates complications that must be detected and treated on time. Objective: To estimate the incidence of some complications of nutritional support in patients admitted to general hospital wards who received nutritional support in six high-complexity institutions. Methods: Prospective, descriptive and multicentric study in patients with nutritional support; the variables studied were medical diagnosis, nutritional condition, nutritional support duration, approach, kind of formula, and eight complications. Results: A total of 277 patients were evaluated; 83% received enteral nutrition and 17% received parenteral nutrition. Some 69.3% presented risk of malnourishment or severe malnourishment at admittance. About 35.4% of those receiving enteral nutrition and 39.6% of the ones who received parenteral nutrition had complications; no significant difference per support was found (p = 0.363). For the enteral nutrition, the most significant complication was the removal of the catheter (14%), followed by diarrhea (8.3%); an association between the duration of the enteral support with diarrhea, constipation and removal of the catheter was found (p < 0.05). For parenteral nutrition, hyperglycemia was the complication of highest inci­dence (22.9%), followed by hypophosphatemia (12.5%); all complications were associated with the duration of the support (p < 0.05). Nutritional support was suspended in 24.2% of the patients. Conclusions: Complications with nutritional support in hospital-ward patients were frequent, with the removal of the catheter and hyperglycemia showing the highest incidence. Duration of the support was the variable that revealed an asso­ciation with complications. Strict application of protocols could decrease the risk for complications and boost nutritional support benefits.

scholarly journals A Case of Nosocomial Outbreak of Pantoea agglomerans Related to Parenteral Nutrition Procedures

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 684
Author(s):  
Dora Mirtella ◽  
Piergiorgio Fedeli ◽  
Roberto Scendoni ◽  
Nunzia Cannovo ◽  
Mariano Cingolani
Keyword(s):  
Parenteral Nutrition ◽  
Soft Tissues ◽  
Penetrating Trauma ◽  
Opportunistic Pathogen ◽  
Pantoea Agglomerans ◽  
Blood Products ◽  
Anesthetic Agents ◽  
Source Of Infection ◽  
Joint Infections ◽  
Hospital Wards

Pantoea agglomerans is a Gram-negative bacterium that infrequently infects humans. Most reports involving it are about infections in soft tissues or bone/joint infections caused by contamination from soil or penetrating trauma by vegetation, such as thorns and splinters. More frequently, it is found as an opportunistic pathogen in immunocompromised patients. It is not rare to find reports of bacteremia and sepsis from contamination of intravenous fluid, parenteral nutrition, blood products and anesthetic agents—that is, through contamination of medical devices and products. We reported a bacterial infection epidemic occurred in 2011 in a hospital in middle Italy which involved different hospital wards; Pantoea agglomerans was isolated from blood cultures of all infected patients and the source of infection was identified in contaminated parenteral nutrition prepared from the local pharmacy.

scholarly journals Cause of death and significant disease found at autopsy

2019 ◽  
Vol 475 (6) ◽  
pp. 781-788 ◽  
Author(s):  
Niklas Friberg ◽  
Oscar Ljungberg ◽  
Erik Berglund ◽  
David Berglund ◽  
Richard Ljungberg ◽  
...  
Keyword(s):  
Developed Countries ◽  
University Hospitals ◽  
Adult Age ◽  
Academic Hospitals ◽  
High Prevalence ◽  
Clinical Diagnoses ◽  
Cerebrovascular Lesion ◽  
Hospital Wards ◽  
Significant Disease ◽  
Over Time

Abstract The use of clinical autopsy has been in decline for many years throughout healthcare systems of developed countries despite studies showing substantial discrepancies between autopsy results and pre-mortal clinical diagnoses. We conducted a study to evaluate over time the use and results of clinical autopsies in Sweden. We reviewed the autopsy reports and autopsy referrals of 2410 adult (age > 17) deceased patients referred to two University hospitals in Sweden during two plus two years, a decade apart. There was a decline in the number of autopsies performed over time, however, mainly in one of the two hospitals. The proportion of autopsy referrals from the emergency department increased from 9 to 16%, while the proportion of referrals from regular hospital wards was almost halved. The autopsies revealed a high prevalence of cardiovascular disease, with myocardial infarction and cerebrovascular lesion found in 40% and 19% of all cases, respectively. In a large proportion of cases (> 30%), significant findings of disease were not anticipated before autopsy, as judged from the referral document and additional data obtained in some but not all cases. In accordance with previous research, our study confirms a declining rate of autopsy even at tertiary, academic hospitals and points out factors possibly involved in the decline.

scholarly journals Assessing Non-Invasive Liver Function in Patients with Intestinal Failure Receiving Total Parenteral Nutrition—Results from the Prospective PNLiver Trial

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1217
Author(s):  
Elisabeth Blüthner ◽  
Ulrich-Frank Pape ◽  
Martin Stockmann ◽  
Mirjam Karber ◽  
Sebastian Maasberg ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Parenteral Nutrition ◽  
Laboratory Tests ◽  
Intestinal Failure ◽  
Liver Function Tests ◽  
Standard Laboratory ◽  
Non Invasive ◽  
Function Tests ◽  
Over Time

Liver abnormalities in intestinal failure (IF) patients receiving parenteral nutrition (PN) can progress undetected by standard laboratory tests to intestinal failure associated liver disease (IFALD). The aim of this longitudinal study is to evaluate the ability of non-invasive liver function tests to assess liver function following the initiation of PN. Twenty adult patients with IF were prospectively included at PN initiation and received scheduled follow-up assessments after 6, 12, and 24 months between 2014 and 2019. Each visit included liver assessment (LiMAx [Liver Maximum Capacity] test, ICG [indocyanine green] test, FibroScan), laboratory tests (standard laboratory test, NAFLD [non-alcoholic fatty liver disease] score, FIB–4 [fibrosis-4] score), nutritional status (bioelectrical impedance analysis, indirect calorimetry), and quality of life assessment. The patients were categorized post-hoc based on their continuous need for PN into a reduced parenteral nutrition (RPN) group and a stable parenteral nutrition (SPN) group. While the SPN group (n = 9) had significantly shorter small bowel length and poorer nutritional status at baseline compared to the RPN group (n = 11), no difference in liver function was observed between the distinct groups. Over time, liver function determined by LiMAx did continuously decrease from baseline to 24 months in the SPN group but remained stable in the RPN group. This decrease in liver function assessed with LiMAx in the SPN group preceded deterioration of all other investigated liver function tests during the study period. Our results suggest that the liver function over time is primarily determined by the degree of intestinal failure. Furthermore, the LiMAx test appeared more sensitive in detecting early changes in liver function in comparison to other liver function tests.

Stability of Human Recombinant Epoetin Alfa in Commonly used Neonatal Intravenous Solutions

1996 ◽  
Vol 30 (5) ◽  
pp. 466-468 ◽  
Author(s):  
Robin K Ohls ◽  
Robert D Christensen
Keyword(s):  
Amino Acids ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Outcome Measures ◽  
Intravenous Fluids ◽  
Sterile Water ◽  
Epoetin Alfa ◽  
Intravenous Tubing ◽  
The Stability ◽  
Over Time

OBJECTIVE: TO measure epoetin alfa concentrations after adding it to a variety of commonly used neonatal intravenous fluids to determine the stability of epoetin alfa over time. DESIGN: Epoetin alfa was added to the following fluids: sterile water; NaCl 0.9%; dextrose 10% in water; dextrose 10% with albumin at concentrations of 0.01 %, 0.05%, and 0.1 %; and total parenteral nutrition solution containing either 0.5% or 2.25% amino acids. The fluid was administered through intravenous tubing, a T-connector, and catheter, and samples were collected at 0,2,4, 8, and 24 hours. MAIN OUTCOME MEASURES: Epoetin alfa concentrations were compared with the measured original preinfusion concentration and recorded as the percentage recovered. RESULTS: Concentrations declined significantly in all fluids containing less than 0.05% protein, but remained stable over 24 hours in fluids containing 0.05% or more protein. CONCLUSIONS: We conclude that epoetin alfa should be mixed in intravenous fluids containing at least 0.05% protein.

scholarly journals Changing the ward culture in a clinic during the implementation of person-centred care

2017 ◽  
Vol 6 (5) ◽  
pp. 31 ◽  
Author(s):  
Axel Wolf ◽  
Kerstin Ulin ◽  
Eric Carlström
Keyword(s):  
Health Care ◽  
Organizational Culture ◽  
Cultural Change ◽  
Cultural Dimensions ◽  
Care Model ◽  
Cross Sectional ◽  
Evidenced Based ◽  
Hospital Wards ◽  
The Impact ◽  
Over Time

Objective: The purpose of this study was to explore the impact of an intervention on the organizational culture in five hospital wards in Sweden. The organizational culture was measured at the start of the project and compared with data collected five years later. The intervention was aimed at changing activities towards a new evidenced-based care model called the Gothenburg Person-centred Care model (PCC).Methods: In total, 230 registered nurses and assistant nurses participated in this cross-sectional health-care culture survey during 2009 and 2014. The Organizational Values Questionnaire was used.Results: The results indicated cultural change in all five wards at the clinic. A dominating culture of flexibility decreased and a culture of routines and structure increased. The wards moved towards a higher degree of cultural uniformity. The combination of cultural dimensions also seems to have become more equal during the study period.Conclusions: Few studies have focussed on the development of organizational culture in health-care contexts over time. The results suggest that the implementation of a new model of care has an impact on organizational culture. This implies that health-care managers should have confidence in the outcomes from change projects. It seems that systems of dual logic can develop over time to facilitate change and sustainability. However, if a new working model is to change the culture profoundly, it requires years of zealous implementation.

scholarly journals PE-22: Variation of Plasma Citrulline Over Time is a Predictive Factor of Weaning Off Parenteral Nutrition in Children with Neonatal SBS

2021 ◽  
Vol 105 (7S) ◽  
pp. S41-S41
Author(s):  
Lambe C ◽  
Lambe C ◽  
Talbotec C ◽  
Chardot C ◽  
Faragelli A ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Predictive Factor ◽  
Plasma Citrulline ◽  
Over Time

Social transmission bias and the cultural evolution of folk-economic beliefs

2018 ◽  
Vol 41 ◽  
Author(s):  
David Hirshleifer ◽  
Siew Hong Teoh
Keyword(s):  
Cultural Evolution ◽  
Social Transmission ◽  
Cognitive Approach ◽  
Economic Problems ◽  
Economic Attitudes ◽  
The Social ◽  
Economic Beliefs ◽  
Over Time

AbstractEvolved dispositions influence, but do not determine, how people think about economic problems. The evolutionary cognitive approach offers important insights but underweights the social transmission of ideas as a level of explanation. The need for asocialexplanation for the evolution of economic attitudes is evidenced, for example, by immense variations in folk-economic beliefs over time and across individuals.

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