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NUTRICION PARENTERAL DOMICILIARIA: COMPLICACIONES Y CALIDAD DE VIDA

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NUTRICION PARENTERAL DOMICILIARIA: COMPLICACIONES Y CALIDAD DE VIDA

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La nutrición parenteral domiciliaria permite la supervivencia prolongada en caso de falla intestinal. La complicación más frecuente es la infección del catéter. Nuestros resultados muestran compromiso moderado de la calidad de vida en la mayoría de los casos.
cuerda.jpg Autor:
Mª Cristina Cuerda Compés
Columnista Experto de SIIC
Artículos publicados por Mª Cristina Cuerda Compés
Coautor
Irene Bretón Lesmes* 
Especialista en Endocrinología y Nutrición, Hospital General Universitario "Gregorio Marañón", Madrid, España*
Recepción del artículo
12 de Agosto, 2003 		Aprobación
23 de Septiembre, 2003
Primera edición
1 de Octubre, 2003 		Segunda edición, ampliada y corregida
7 de Junio, 2021

NUTRICION PARENTERAL DOMICILIARIA: COMPLICACIONES Y CALIDAD DE VIDA

Resumen
Objetivo. Este estudio evalúa las complicaciones sépticas, trombóticas y hepáticas, así como la calidad de vida de los pacientes con nutrición parenteral domiciliaria (NPD). Métodos. Estudiamos 22 pacientes de 50 ± 15 años (m ± DE), tiempo de cateterización de 18 698 días, tratados con NPD en nuestro hospital desde enero de 1986 a julio de 2003. Las principales causas del fracaso intestinal fueron enteritis rádica e isquemia mesentérica. La calidad de vida se evaluó mediante Sickness Impact Profile (SIP) y Karnofsky Index (KI). Resultados. La tasa de infección fue de 0.41/100 días catéter, la mayoría originada por Staphylococcus coagulasa negativo (63%). En el 32% de los casos se retiró el catéter. La tasa de oclusión fue de 0.04/100 días catéter. Durante la NPD, cinco pacientes presentaron elevación de las transaminasas y fosfatasa alcalina, y dos pacientes, colostasis. Hubo tres fallecimiento de causas relacionadas con la NPD. Los resultados de la calidad de vida mostraron afectación moderada, con valoraciones SIP de 14.6 ± 3.5 y KI de 70 ± 20 (m ± DE). Conclusiones. La nutrición parenteral domiciliaria permite una supervivencia prolongada en caso de fallo intestinal. La complicación más frecuente es la infección del catéter. Nuestros resultados muestran afectación moderada de la calidad de vida en la mayoría de los casos.

Palabras clave
Nutrición parenteral domiciliaria, complicaciones


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Extensión:  +/-6.67 páginas impresas en papel A4
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HOME PARENTERAL NUTRITION: COMPLICATIONS AND QUALITY OF LIFE

Abstract
Aim: This study evaluates the septic, thrombotic and hepatic complications and also the quality of life of patients on home parenteral nutrition (HPN).Methods: We studied 22 patients, aged 50 ±15 yr(m ± SD), catheterization time of 18698 days on HPN, followed in our hospital from January 1986 to July 2003. The principal etiologies of the intestinal failure were radiation enteritis and ischemic bowel. Quality of life was assessed by the Sickness Impact Profile (SIP) and the Karnofsky Index (KI).Results: The infection rate was 0,41 /100 catheter days, the majority due to coagulase negative Staphylococcus (61%). In 32% of the cases the catheter was removed. The occlusion rate was 0,04/100 catheter days. Five patients had an increase in transaminases and alkaline phosphatase, and two patients developed cholestasis during HPN. Three patients died of HPN-related causes. The results of the quality of life analysis showed it was moderately affected, with SIP scores of 14,6± 3,5 and KI results of 70±20 (m±SD).Conclusions: Home parenteral nutrition allows a greater survival in cases of intestinal failure. The most frequent complication is the catheter infection. Our results of the quality of life analysis revealed that it was moderately affected in most cases

Key words
Nutrición parenteral domiciliaria, complicaciones

Clasificación en siicsalud
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Especialidades
Principal: Nutrición
Relacionadas: Infectología, Medicina Interna



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Bibliografía del artículo
  1. Scribner B, Cole J et al. Long-term total parenteral nutrition. The concept of an artificial gut. JAMA 1970; 212: 457.
  2. Van Gossum A, Bakker H, Bozzetti F, et al. Home parenteral nutrition in adults: a European multicentre survey in 1997. Clin Nutr 1999; 18: 135-40.
  3. Howard L, Ament M, Fleming CR, Shike M, Steiger E. Current use and clinical outcome of Home Parenteral and Enteral Nutrition therapies in the United States. Gastroenterology 1995; 109: 355-65.
  4. Delegge MH. Demographics of Home Parenteral Nutrition. JPEN 2002; 26: S60-S62.
  5. Centers for Disease Control and Prevention. Guidelines for the prevention of intravascular catheter-related infections. MMWR 2002; 51 (No.RR-10): 1-29.
  6. Planas M, Castella M, León M, et al. Parenteral nutrition at home: NADYA register for the year 2000. Nutr Hosp 2003; 18: 29-33.
  7. Howard L, Hassan N. Home parenteral nutrition: 25 years later. Gastroenterol Clin North Am 1998; 27: 481-512.
  8. O´Hanrahan T, Irving MH. The role of home parenteral nutrition in the management of intestinal failure. Report of 400 cases. Clin Nutr 1992; 11: 331-6.
  9. Bozzetti F. Home total parenteral nutrition in cancer patients. Clin Nutr 1995; 14: 36-40.
  10. Howard L, Ashley C. Management of complications in patients receiving home parenteral nutrition. Gastroenterol 2003; 124: 1651-61.
  11. Bozzetti F, Mariani L, Boggio Bertinet D, et al. Central venous catheter complications in 447 patients on home parenteral nutrition: an analysis of over 100.000 catheter days. Clin Nutr 2002; 21: 475-485.
  12. Moreno JM, Gomis P, Valero MA, León M. Home parenteral nutrition. A six-year combined program (adult and pediatric patients). Med Clin Barc 2000; 114: 617-8.
  13. Llop J, Juvany R, Tubau M, Virgili N, Pita A, Jodar R. Quality of the home parenteral nutrition program: 14 years of experience at a general university hospital. Nutr Hosp 2000; 15: 64-70.
  14. Reimund J, Duclos B, Cuby C, et al. Home parenteral nutrition: clinical and laboratory analysis of initial experience (1994-1997). Implications for patient management. Ann Nutr Metab 1999; 43: 329-38.
  15. Reimund JM, Arondel Y, Finck G, Zimmermann F, Duclos B, Baumann R. Catheter-related infection in patients on home parenteral nutrition: results of a prospective survey. Clin Nutr 2002; 21: 33-38.
  16. Buchman AL, Moukarzel A, Goodson B, et al. Catheter-related infections associated with home parenteral nutrition and predictive factors for the need for catheter removal in their treatment. JPEN 1994; 18: 297-302.
  17. Messing B. Catheter-related sepsis during home parenteral nutrition. Clin Nutr 1995; 14: 46-51.
  18. Colomb V, Fabeiro M, Dabbas M, Goulet O, Merckx J, Ricour C. Central venous catheter-related infections in children on long-term home parenteral nutrition: incidence and risk factors. Clin Nutr 2000; 19: 355-9.
  19. Messing B, Man F, Colimon R, Thuillier F, Beliah M. Antibiotic lock technique is an effective treatment of bacterial catheter-related sepsis during parenteral nutrition. Clin Nutr 1990; 9: 220-5.
  20. Santarpia L, Pasanisi F, Alfonsi L, et al. Prevention and treatment of implanted central venous catheter (CVC)-related sepsis: a report after six years of home parenteral nutrition (HPN). Clin Nutr 2002; 21: 207-211.
  21. Maroulis J, Kalfarentzos F. Complications of parenteral nutrition at the end of the century. Clin Nutr 2000; 19: 295-304.
  22. Linares J, Sitges Serra A, Garav J, Pérez JL, Martin R. Pathogenesis of catheter sepsis: a prospective study with quantitative and semiquantitative cultures of catheter hub and segments. J Clin Microbiol 1985; 21: 357-60.
  23. Miller SJ, Dickerson RN, Graziani AA, Muscari EA, Mullen JL. Antibiotic therapy of catheter infections in patients receiving home parenteral nutrition. JPEN 1990; 14: 143-7.
  24. Benoit JL, Carandang G, Sitrin M, Arnow PM. Intraluminal antibiotic treatment of central venous catheter infections in patients receiving parenteral nutrition at home. Clin Infect Dis 1995; 21: 1286-8.
  25. Messing B, Peitra-Cohen S, Debure A, Beliah M, Bernier JJ. Antibiotic-lock technique: a new approach to optimal therapy for catheter-related sepsis in home-parenteral nutrition patients. JPEN 1988; 12: 185-9.
  26. Guedon C, Nouvellon M, lalaude O, Lerebours E. Efficacy of antibiotic-lock technique with teicoplanin in staphylococcus epidermidis catheter-related sepsis during long-term parenteral nutrition. JPEN 2002; 26: 109-113.
  27. Williams NMA, Wales S, Scott NA, Irving MH. The incidence and management of catheter occlusion in patients on home parenteral nutrition. Clin Nutr 1993; 12: 344-9.
  28. Haire WD, Leibermann RP. Thrombosed central venous catheters, restoring function with 6-hours urokinase infusion after bolus urokinase. JPEN 1992; 16: 129-32.
  29. Pennington CR. Central vein thrombosis during home parenteral nutrition. Clin Nutr 1995; 14: 52-5.
  30. Oley Foundation 1992. North American home parenteral and enteral patient registry: annual report with patient profiles 1985-1990.
  31. Fabri PJ, Mirtallo JM, Ruberg R, et al. Incidence and prevention of thrombosis of subclavian vein. Surg Gynecol Obstet 1982; 155: 238-40.
  32. Bern MM, Bothe A, Bristian B, et al. Prophylaxis against central vein thrombosis with low dose warfarin. Surgery 1986; 99: 216-21.
  33. Bern MM, Lockich J, Wallach SR, et al. Very low doses of warfarin can prevent thrombosis in central venous catheters. Ann Intern Med 1990; 112: 423-8.
  34. Monreal M, Alastrue A, Rull M, et al. Upper extremity deep venous thrombosis in cancer patients with venous access devices. Prophylaxis with a low molecular weight heparin (Fragmin). Thromb Haemost 1996; 75: 251-3.
  35. Buchman A. Total parenteral nutrition-associated liver disease. J 2002; 26: S43-S48.
  36. Shaffer JL. Hepatic complications of parenteral nutrition. Clin Nutr 1995; 14: 59-64.
  37. Bowyer BA, Fleming CR, Ludwig J, Petz J, McGill DB. Does long-term home parenteral nutrition in adult patients cause chronic liver disease JPEN 1985; 9: 11-7.
  38. Cavicchi M, Beau P, Crenn P, Degott C, Messing B. Prevalence of liver disease and contributing factors in patients receiving home parenteral nutrition for permanent intestinal failure. Ann Intern Med 2000; 132: 525-32.
  39. Chan S, McCowen KC, Bristian BR, et al. Incidence, prognosis, and etiology of end-stage liver disease in patients receiving home total parenteral nutrition. Surgery 1999; 126: 28-34.
  40. Kaminski DL, Adams A, Jellinek M. The effect of hyperalimentation on hepatic lipid content and lipogenic enzyme activity in rats and man. Surgery 1980; 88: 93-100.
  41. Buzby GF, Mullen JL, Stein TP, Rosato EF. Manipulation of TPN caloric substrate and fatty infiltration of the liver. J Surg Res 1981; 31: 46-54.
  42. Rubin M, Moser A, Vaserberg N, et al. Structured triacylglycerol emulsion, containing both medium- and long- chain fatty acids, in long-term home parenteral nutrition: a double-blind randomized cross-over study. Nutrition 2000; 16: 95-100.
  43. Yeh SL, Lin MT, Chen WJ. MCT/LCT emulsion ameliorate liver fat deposition in insulin-treated diabetic rats receiving total parenteral nutrition. Clin Nutr 1998; 17: 273-7.
  44. McCowen KC, Burke PA, Bristian BR. Liver disease and home parenteral nutrition. Ann Intern Med 2000; 133: 1009-10.
  45. Buchman AL, Ament ME, Sohel M, et al. Choline deficiency causes reversible hepatic abnormalities in patients receiving parenteral nutrition: Proof of a human choline requeriment: A placebo-controlled trial. JPEN 2001; 25: 260-8.
  46. Van Gossum A, Peeters I, Lievin V. Home parenteral nutrition in adults: the current use of an experienced method. Acta Gastroenterol Belg 1999; 62: 201-9.
  47. Scolapio JS, Fleming CR, Kelly DG, Wick DM, Zinsmeister AR. Survival of home parenteral nutrition-treated patients: 20 years of experience at the Mayo Clinic. Mayo Clin Proc 1999; 74: 217-22.
  48. Howard L, Heaphey LL, Flemming CR, Lininger L, Steiger E. Four years of North American Registry HPN: outcome data and their implications for patient management. JPEN 1991; 15: 384-94.
  49. Messing B. Long-term outcome and quality of life of adult patients on home parenteral nutrition. Clin Nutr 1995; 14: 24-7.
  50. Jeppesen PB, Langholz E, Mortensen PB. Quality of life in patients receiving home parenteral nutrition. Gut 1999; 44: 844-52.
  51. Richards DM, Irving MH. Assessing the quality of life of patients with intestinal failure on home parenteral nutrition. Gut 1997; 40: 218-22.
  52. Smith CE. Quality of life in long-term total parenteral nutrition patients and their family caregivers. JPEN 1993; 17: 501-6.
  53. Carlson GL, Maguire G, Williams N, Bradley A, Shaffer JL, Irving MH. Quality of life on home parenteral nutrition: a single centre study of 37 patients. Clin Nutr 1995; 14: 219-28.
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Especialidad principal:
Nutrición


Relacionadas:
Infectología
Medicina Interna
 
 
 
 
 
 
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