INTRODUCTION:The most severe complication of parenteral nutrition (PTN) is catheter-related infection (CRI). OBJECTIVES:To study the incidence rate and factors associated to CRI. MATERIAL AND METHODS:271 patients followed at the Nutrition Unit for 6 months. The composition of the PTN was calculated according to the metabolic demands. 20.3% received a lipid solution enriched with omega-3 fatty acids (SMOF Fresenius Kabi®) and 79.7% with olive oil (Clinoleic Baxter®). RESULTS:The rate of CRI was 25 per 1,000 days of PTN (55 patients: 61.7±17.8 years, 60.3% males, 29.3±10.6 days of hospital stay and 10.4% mortality). Coagulase-negative Staphylococcus was the most frequently isolated microorganism. There were no differences by age, gender, mortality, or composition of the PTN between patients with or without infection. The patients treated with omega-3 received more calories with the PTN, at the expense of higher intake of glucose and lipids. However, the rate of infection was similar, although there was a not significant trend towards a lower infection rate when using the omega-3 composition (14.5% vs. 23.1%, respectively, p = 0.112). The duration of the nutritional support was higher in patients with CRI (13.0 ± 9.7 vs. 9.3 ± 8.1, p = 0.038). Total mortality (16.9%) was independent of the presence or absence of CRI (10.4% vs. 18.7%, p = 0.090) or of the use of omega-3 lipids or olive oil in the PTN (10.9% vs. 18.5%, p = 0.125). CONCLUSION:Patients submitted to PTN have a high rate of CRI. The presence of infection is related to the duration of the PTN, being independent of the age, gender, and composition of the solution. The use of omega-3 lipid solutions may be beneficial although further studies are needed to confirm this.

译文

简介:肠胃外营养(PTN)的最严重并发症是导管相关感染(CRI)。
目的:研究CRI的发生率及相关因素。
材料与方法:271例患者在营养科接受了6个月的随访。根据代谢需要计算PTN的组成。 20.3%的人接受了富含omega-3脂肪酸(SMOF FreseniusKabi®)的脂质溶液,而79.7%的接受了橄榄油(ClinoleicBaxter®)的脂质溶液。
结果:PTN的CRI率为每1000天25(55例患者:61.7±17.8岁,男性为60.3%,住院时间为29.3±10.6天,死亡率为10.4%)。凝固酶阴性葡萄球菌是最常分离的微生物。在有或没有感染的患者之间,PTN的年龄,性别,死亡率或组成没有差异。用omega-3治疗的患者接受PTN吸收的卡路里更多,但要以增加葡萄糖和脂质的摄入为代价。但是,感染率相似,尽管使用omega-3组合物时感染率降低的趋势并不明显(分别为14.5%和23.1%,p = 0.112)。 CRI患者的营养支持持续时间更长(13.0±9.7与9.3±8.1,p = 0.038)。总死亡率(16.9%)与是否存在CRI(10.4%对18.7%,p = 0.090)或PTN中是否使用omega-3脂质或橄榄油无关(10.9%对18.5%, p = 0.125)。
结论:提交PTN的患者的CRI率很高。感染的存在与PTN的持续时间有关,而与溶液的年龄,性别和组成无关。尽管需要进一步的研究来证实这一点,但使用omega-3脂质溶液可能是有益的。

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