scholarly journals Supplemental Parenteral Nutrition in Patients with Cancer

2021 ◽  
Author(s):  
Federico Bozzetti
Keyword(s):  
Parenteral Nutrition ◽  
Patients With Cancer ◽  
Supplemental Parenteral Nutrition

scholarly journals The clinical and cost-effectiveness of supplemental parenteral nutrition in oncology

ESMO Open ◽  
2020 ◽  
Vol 5 (3) ◽  
pp. e000709 ◽  
Author(s):  
Neil Webb ◽  
Julie Fricke ◽  
Elizabeth Hancock ◽  
David Trueman ◽  
Srobana Ghosh ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Literature Review ◽  
Parenteral Nutrition ◽  
Severe Disease ◽  
Cost Utility ◽  
Fat Free Mass ◽  
Published Data ◽  
Potential Cost ◽  
Patients With Cancer ◽  
Supplemental Parenteral Nutrition

BackgroundClinical guidelines recommend that parenteral nutrition (PN) is added to enteral nutrition (EN; supplemental parenteral nutrition (SPN)) in order to meet energy and protein needs in patients with cancer when EN alone is insufficient. However, although cancer-related malnutrition is common, there is poor awareness of the value of nutritional care, resulting in SPN being chronically underused.MethodsWe performed a targeted literature review and exploratory cost-utility analysis to gather evidence on the clinical effectiveness of SPN, and to estimate the potential cost-effectiveness of SPN versus EN alone in an example cancer setting.ResultsThe literature review identified studies linking SPN with malnutrition markers, and studies linking malnutrition markers with clinical outcomes. SPN was linked to improvements in body mass index (BMI), fat-free mass, phase angle (PhA) and prealbumin. Of these markers, BMI and PhA were strong predictors of survival. By combining published data, we generated indirect estimates of the overall survival HR associated with SPN; these ranged from 0.80 to 0.99 (mode 0.87). In patients with Stage IV inoperable pancreatic cancer, the incremental cost-effectiveness ratio versus EN alone was estimated to be £41 350 or £91 501 depending on whether nursing and home delivery costs for EN and SPN were combined or provided separately.ConclusionDespite a lack of direct evidence, the results of the literature review demonstrate that SPN may provide important clinical and quality of life benefits to patients with cancer. The potential for any improvement in outcomes in the modelled patient population is very limited, so cost-effectiveness may be greater in patients with less severe disease and other types of cancer.

The place of supplemental parenteral nutrition in critically ill transplanted patients: A one year retrospective study

2018 ◽  
Vol 37 ◽  
pp. S170 ◽  
Author(s):  
M. Theilla ◽  
I. Kagan ◽  
M. Makalde ◽  
S. Rattanachaiwong ◽  
J. Cohen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Parenteral Nutrition ◽  
Critically Ill ◽  
Supplemental Parenteral Nutrition ◽  
One Year

Parenteral Nutrition in Cancer Patients Undergoing Chemotherapy (DRAFT)

2018 ◽  
Author(s):  
Francisco Loaiciga ◽  
Rony Dev
Keyword(s):  
Parenteral Nutrition ◽  
Cancer Patients ◽  
Nutritional Support ◽  
Clinical Case ◽  
Detrimental Effect ◽  
Tumor Response ◽  
Meta Analysis ◽  
Infection Risk ◽  
Gastrointestinal Toxicity ◽  
Patients With Cancer

The meta-analysis by McGeer investigates the benefits of parenteral nutritional support for patients with cancer undergoing chemotherapy. The study concluded that total parenteral nutrition (TPN) has a detrimental effect (decreased survival and poorer tumor response), with an increased infection risk but no significant effect on hematologic or gastrointestinal toxicity. The authors report a net harm with the use of TPN in patients undergoing chemotherapy and recommend that such interventions should be discouraged. This chapter describes the basics of the study, briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

scholarly journals Early Supplemental Parenteral Nutrition in Critically Ill Children: An Update

2019 ◽  
Vol 8 (6) ◽  
pp. 830 ◽  
Author(s):  
An Jacobs ◽  
Ines Verlinden ◽  
Ilse Vanhorebeek ◽  
Greet Van den Berghe
Keyword(s):  
Parenteral Nutrition ◽  
Critically Ill ◽  
Controlled Trial ◽  
Severity Of Illness ◽  
Pediatric Intensive Care ◽  
Optimal Dose ◽  
Adverse Outcomes ◽  
Critically Ill Children ◽  
Clinical Practices ◽  
Supplemental Parenteral Nutrition

In critically ill children admitted to pediatric intensive care units (PICUs), enteral nutrition (EN) is often delayed due to gastrointestinal dysfunction or interrupted. Since a macronutrient deficit in these patients has been associated with adverse outcomes in observational studies, supplemental parenteral nutrition (PN) in PICUs has long been widely advised to meeting nutritional requirements. However, uncertainty of timing of initiation, optimal dose and composition of PN has led to a wide variation in previous guidelines and current clinical practices. The PEPaNIC (Early versus Late Parenteral Nutrition in the Pediatric ICU) randomized controlled trial recently showed that withholding PN in the first week in PICUs reduced incidence of new infections and accelerated recovery as compared with providing supplemental PN early (within 24 hours after PICU admission), irrespective of diagnosis, severity of illness, risk of malnutrition or age. The early withholding of amino acids in particular, which are powerful suppressors of intracellular quality control by autophagy, statistically explained this outcome benefit. Importantly, two years after PICU admission, not providing supplemental PN early in PICUs did not negatively affect mortality, growth or health status, and significantly improved neurocognitive development. These findings have an important impact on the recently issued guidelines for PN administration to critically ill children. In this review, we summarize the most recent literature that provides evidence on the implications for clinical practice with regard to the use of early supplemental PN in critically ill children.

PP001-MON SPN STUDY: SUPPLEMENTAL PARENTERAL NUTRITION (SPN) TO REACH ENERGY TARGET DOES NOT COMPROMISE GLUCOSE CONTROL

2012 ◽  
Vol 7 (1) ◽  
pp. 138-139 ◽  
Author(s):  
S. Graf ◽  
M.M. Berger ◽  
A. Clerc ◽  
V. Brancato ◽  
C.P. Heidegger ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Glucose Control ◽  
Supplemental Parenteral Nutrition

Supplemental Parenteral Nutrition Does Not Increase Mortality in Children

2000 ◽  
Vol 21 ◽  
pp. S234 ◽  
Author(s):  
R. Sheridan ◽  
K. Prelack ◽  
P. Kadillack ◽  
C. Ryan ◽  
J. Schulz ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Supplemental Parenteral Nutrition
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