Infections associated with parenteral nutrition

Opilla M. Epidemiology of bloodstream infection associated with parenteral nutrition. Am J Infect Control 2008 36(10) S173. e5-8. 

Aguilella Vizcaino MJ, Valero Zanuy MA, Gastalver Martin C, Gomis Munoz P, Moreno Villares JM, Le6n Sanz M. Incidence of catheter-related infection and associated risk factors in hospitalized patients with parenteral nutrition. [Article in Spanish] Nutr Hosp 2012 May-Jun 27(3) 889-93. 

Maintaining adequate nutritional status, especially during periods of illness and metabolic stress, is an important part of patient care. Malnutrition in hospitalized patients is associated with significant complications, including increased infection risk, poor wound healing, prolonged hospital stay, and increased mortality, especially in surgical and critically ill patients.1 Specialized nutrition support refers to the administration of nutrients via the oral, enteral, or parenteral route for therapeutic purposes.1 Parenteral nutrition (PN), also... 

Parenteral nutrition can be a lifesaving therapy in patients with intestinal failure, but the oral or enteral route is preferred when providing nutrition support ( when the gut works, use it ). Compared with PN, enteral nutrition generally is associated with fewer infectious complications (e.g., pneumonia, intraabdominal abscess, and catheter-related infections) and potentially improved outcomes.1-3 However, if used in appropriate patients (i.e., patients with questionable intestinal function or when the intestine cannot be used), PN can be used safely and effectively and may improve nutrient delivery.4 Indications for PN are listed in Table 97-1.1... 

Shay DK, Fann LM, Jarvis WR. Respiratory distress and sudden death associated with receipt of a peripheral parenteral nutrition admixture. Infect Control Hosp Epidemiol 1997 18(12) 814-17. 

Total parenteral nutrition is a lifesaving adjunct in surgical care. Diligent attention to detail, insures that infection in association with this therapy, is kept at acceptable levels. 

Similarly, early administration of parenteral nutrition after severe injury was associated with an increased risk of nosocomial infections in a retrospective cohort study of 567 patients, of whom 95... 

In a prospective cohort study including 24 infants, the incidence and risk factors of parenteral nutrition-associated liver disease (PNALD) was determined. Eight infants developed PNALD. The concluded that the duration of enteral starvation, gastrointestinal surgery, duration of enteral nutrition, maximum caloric and carbohydrate intakes were significant risks of PNALD in newborn infants [lob ll. In a retrospective review of the safety and efficacy of PN among 105 paediatric patients with bum injuries (>30% total-body sxuface area), no respiratory or blood infections were observed with the use of parenteral nutrition, and the overall mortality rate was 4% [107 ]. 

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