Evaluation of non-infectious complications in children receiving parenteral nutrition.

Abstract

BACKGROUND:

Parenteral nutrition may lead to inevitable complications.

AIMS:

To determine the indications, metabolic and mechanical complications of parenteral nutrition in children.

METHODS:

One hundred fifty-eight children (91 males; 57.8%) who received 179 episodes of individualized parenteral nutrition for ≥ 5 days within 2 years were analyzed. Indications and duration of parenteral nutrition, effect on growth, and metabolic and central venous catheter-related non-infectious complications were evaluated.

RESULTS:

Parenteral nutrition was administered in 179 different episodes (109 males; 60.9%), and the median age during these episodes was 64.0 (14.0-129.0) months. The most common indications were hematological malignancies, gastrointestinal surgery, and hematopoietic stem cell transplantation. Most of the electrolyte imbalances occurred in the first 3 days. Hypophosphatemia (44.7%), hypomagnesemia (43.0%), hypokalemia (43.0%), hyponatremia (40.8%), and hypertriglyceridemia (38.2%) were the most common metabolic complications. Liver transaminases elevated in 32/145 (22.1%) episodes and bilirubin in 30/149 (21.0%). Ursodeoxycholic acid treatment was added to 25 patients with hypertransaminasemia and/or hyperbilirubinemia. Transaminase levels improved in 16 (64%) and bilirubin levels in 15 (60%) patients receiving ursodeoxycholic acid. Catheter thrombosis was seen in 4.5% of the episodes. The targeted energy could be given more efficiently via central catheters rather than peripheral venous accesses. Patients' bodyweights increased in 39.1% of the episodes.

CONCLUSIONS:

Close monitoring of electrolyte levels, especially in the first 3 days, is crucial to prevent complications of parenteral nutrition. When individualized PN preparations are used for metabolically unstable patients, it can be easier to maintain the blood glucose, lipids, and electrolyte levels within the normal range.

• Authors: Zeynelabidin Ozturk, Hulya Demir, Asuman Nur Karhan, Inci Nur Saltik Temizel, Hasan Özen
• Journal: Irish journal of medical science (Ir J Med Sci) Vol. 192 Issue 6 Pg. 2735-2739 (Dec 2023) ISSN: 1863-4362 [Electronic] Ireland
• PMID: 36849650 (Publication Type: Journal Article)
• Copyright: © 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

Chemical References

• Ursodeoxycholic Acid
• Bilirubin
• Electrolytes

Topics

• Male
• Humans
• Child
• Child, Preschool
• Ursodeoxycholic Acid
• Parenteral Nutrition (adverse effects)
• Liver
• Bilirubin
• Electrolytes