Total parenteral nutrition usage trends in the United States

2017 ◽  
Vol 40 ◽  
pp. 312-313 ◽  
Author(s):  
Jason John ◽  
Ali Seifi
Keyword(s):  
United States ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
The United States

scholarly journals Aluminum in Pediatric Parenteral Nutrition Products: Measured Versus Labeled Content

2011 ◽  
Vol 16 (2) ◽  
pp. 92-97
Author(s):  
Robert L. Poole ◽  
Kevin P. Pieroni ◽  
Shabnam Gaskari ◽  
Tessa K. Dixon ◽  
KT Park ◽  
...  
Keyword(s):  
United States ◽  
Parenteral Nutrition ◽  
Clinical Setting ◽  
Aluminum Content ◽  
The United States ◽  
Published Data ◽  
Measured Concentration ◽  
Aluminum Exposure ◽  
Product Release

ABSTRACT OBJECTIVE Aluminum is a contaminant in all parenteral nutrition solutions. Manufacturers currently label these products with the maximum aluminum content at the time of expiry, but there are no published data to establish the actual measured concentration of aluminum in parenteral nutrition solution products prior to being compounded in the clinical setting. This investigation assessed quantitative aluminum content of products commonly used in the formulation of parenteral nutrition solutions. The objective of this study is to determine the best products to be used when compounding parenteral nutrition solutions (i.e., those with the least amount of aluminum contamination). METHODS All products available in the United States from all manufacturers used in the production of parenteral nutrition solutions were identified and collected. Three lots were collected for each identified product. Samples were quantitatively analyzed by Mayo Laboratories. These measured concentrations were then compared to the manufacturers' labeled concentration. RESULTS Large lot-to-lot and manufacturer-to-manufacturer differences were noted for all products. Measured aluminum concentrations were less than manufacturer-labeled values for all products. CONCLUSIONS The actual aluminum concentrations of all the parenteral nutrition solutions were significantly less than the aluminum content based on manufacturers' labels. These findings indicate that 1) the manufacturers should label their products with actual aluminum content at the time of product release rather than at the time of expiry, 2) that there are manufacturers whose products provide significantly less aluminum contamination than others, and 3) pharmacists can select products with the lowest amounts of aluminum contamination and reduce the aluminum exposure in their patients.

scholarly journals Survey of Clinical Nutrition Practices of Canadian Gastroenterologists

2006 ◽  
Vol 20 (8) ◽  
pp. 527-530 ◽  
Author(s):  
Harminder Singh ◽  
Donald R Duerksen
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Nutritional Assessment ◽  
Training Programs ◽  
The United States ◽  
Clinical Nutrition ◽  
Nutrition Support ◽  
Full Time ◽  
Canadian Association ◽  
Nutrition Training

OBJECTIVE: Nutrition education is a required part of gastrointestinal training programs. The involvement of gastroenterologists in clinical nutrition once their training has been completed is unknown. The aim of the present study was to determine the practice pattern of gastroenterologists in clinical nutrition and their perceived adequacy of nutrition training during their gastroenterology (GI) fellowship.METHODS: The Canadian Association of Gastroenterology mailed a survey to all of its 463 Canadian clinician members and 88 trainee members. Components of the survey included knowledge of nutritional assessment and total parenteral nutrition, involvement in a nutrition support service, physician involvement in nutritional assessment and nutrition support teams, obesity management, insertion of gastrostomy (G) tubes and management of tube-related complications, and adequacy of training in clinical nutrition.RESULTS: Sixty per cent (n=279) of the Canadian Association of Gastroenterology clinicians and 38% (n=33) of the fellows responded. Of the clinicians, 80% were practicing adult gastroenterologists with the following demographics: those practicing full time in academic centres (42%), community practice (45%), completed training in the last 10 years (32%) and those that completed training in the United States (14%). Although only 6% had a primary focus of nutrition in their GI practices, 65% were involved in nutrition support (including total parenteral nutrition), 74% placed G tubes and 68% managed at least one of the major complications of G tube insertion. Respondents felt a gastroenterologist should be the physician’s consultant on nutrition support services (89%). Areas of potential inadequate training included nutritional assessment, indications for nutrition support, management of obesity and management of G tube-related complications. The majority of clinicians (67%) and trainees (73%) felt that nutrition training in their GI fellowship was underemphasized.CONCLUSIONS: The majority of Canadian gastroenterologists are involved in nutrition support. However, this survey demonstrated that nutritional training is underemphasized in most training programs. It is important for GI fellowship programs to develop standardized nutrition training that prepares trainees for their practice.

Anemia and Leukopenia in a Long-Term Parenteral Nutrition Patient During a Shortage of Parenteral Trace Element Products in the United States

2012 ◽  
Vol 37 (3) ◽  
pp. 425-429 ◽  
Author(s):  
Pornpoj Pramyothin ◽  
Dong Wook Kim ◽  
Lorraine S. Young ◽  
Sanit Wichansawakun ◽  
Caroline M. Apovian
Keyword(s):  
United States ◽  
Parenteral Nutrition ◽  
Trace Element ◽  
The United States

Does use of total parenteral nutrition in patients with metastatic gastrointestinal cancer impact hospice length of stay?

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 58-58
Author(s):  
Jessica J Bian ◽  
Rachel S Rome ◽  
Angela Marie Taber
Keyword(s):  
Length Of Stay ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Cancer Patients ◽  
Gastrointestinal Cancer ◽  
The United States ◽  
Gastrointestinal Cancers ◽  
Single Institution ◽  
Median Length ◽  
The Impact

58 Background: The use of total parenteral nutrition (TPN) in metastatic cancer patients is controversial. The impact of TPN use on length of hospice stay in advanced cancer patients is unknown. We hypothesize that patients with metastatic gastrointestinal cancers who receive TPN have a shorter median length of hospice stay as compared to the median hospice length of stay for cancer patients in the United States in 2014 (18 days). The primary objective of our retrospective, single-institution study is to determine the median hospice length of stay in patients with metastatic gastrointestinal cancers who received TPN. Methods: Records of all adult patients with metastatic gastrointestinal cancers who received TPN at The Lifespan Cancer Institute from 2005 through 2014 were reviewed. The primary outcome was median hospice length of stay. Data analysis was conducted using Stata (Version 15.0, StataCorp, College station, Texas). Results: Seventy-nine patients were identified as having received TPN for metastatic gastrointestinal cancer. Forty-eight patients had documented referrals to hospice and 40 patients had assessable durations of hospice admission. Hospice length of stay ranged from one to 196 days with a median of 9.5 days, mean of 24.3 days, and interquartile range of 5.5 to 54 days. Conclusions: Hospice care has been shown to improve quality of life for patients and caregivers. In our retrospective, single-institution study of patients with metastatic gastrointestinal cancer who received TPN, the median hospice length of stay was shorter than the national median length of hospice stay for cancer patients in 2014 (9.5 days versus 18 days). This should be taken into consideration when weighing the risks and benefits of initiating TPN in metastatic gastrointestinal cancer patients. [Table: see text]

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