Complicações e desfechos clínicos de pacientes em uso de nutrição parenteral em um hospital público do Distrito Federal

Abstract

Introduction: Parenteral nutrition has become an effective alternative for caloric-protein supply in hospitalized patients. The objective of this study is to evaluate the use, complications and clinical outcomes of patients using parenteral nutrition. Methods: Analytical, quantitative, longitudinal, retrospective study with patients admitted to a public hospital. The variables analyzed were: sex, age, presence of malnutrition, nutritional risk, achievement of nutritional goals, reason for indication, type of access, time of use, present complications and deaths. Results: The sample consisted of 62 patients aged 55.1±17.95 years old. Total parenteral nutrition was found more frequently (61%; n=38) and used within 30 days (74%; n=28). As indicated, the postoperative period was prevalent in 45.2% (n=28) of the cases. Nutritional risk (58.1%, n=36) and malnutrition (40.3%; n=25) were prevalent. Hyperglycemia (50%; n=31) and water retention (48.4%; n=30) were the most frequent complications. The presence of water retention increased the chances of death by 3.75 times (OR=3.75; 95%IC 1.25-11.24; p=0.018). Conclusion: The indication of parenteral nutrition was prevalent in postoperative situations, in patients with nutritional risk and malnutrition. Hyperglycemia was the most observed complication and the presence of water retention associated with a higher risk of mortality when using this therapy.

Alimentação parenteral: principais complicações decorrentes de seu uso / Parenteral nutrition: main complications resulting from it's use

“…( 17) Em uma porcentagem menor, porém também considerável, observou-se a presença de flebite. Sendo tal complicação potencialmente diminuída quando a utilização da NP se limitar, quando possível, a tempo máximo de 14 dias (16).…”

“…Na nutrição parenteral total (NPT), a via de administração é um acesso venoso central, podendo permanecer por um período maior de tempo, com a possibilidade de administrar solução de glicose, emulsão lipídica, aminoácidos, vitaminas e minerais. Além de ter maior tolerabilidade a soluções hiperosmolares, devido ao alto fluxo sanguíneo (16).…”

Assessment of technical knowledge on oral nutritional therapy between physicians and the nursing team of a private institution

“…[36] Nutritional education interventions, such as the creation of workshops, protocols and discussion of clinical cases, increase the quality of nutritional therapy, this study also points out that there was an improvement in clinical practice after the application of training for physicians, impacting on a shorter period of fasting and greater achievement of nutritional goals. [37] Nutritional diagnosis must be carried out in parallel with disease diagnosis so that early nutritional intervention is possible, thus affording better clinical outcomes. [38] The present study has some limitations, such as the use of a questionnaire designed for this study, based on other similar research, but not validated.…”