Bischoff S C, Kester L, Meier R, Radziwill R, Schwab D, Thul P
Dept. Nutritional Medicine and Prevention, University Stuttgart-Hohenheim, Germany.
Ger Med Sci. 2009 Nov 18;7:Doc20. doi: 10.3205/000079.
PN (parenteral nutrition) should be standardised to ensure quality and to reduce complications, and it should be carried out in consultation with a specialised nutrition support team whenever possible. Interdisciplinary nutrition support teams should be established in all hospitals because effectiveness and efficiency in the implementation of PN are increased. The tasks of the team include improvements of quality of care as well as enhancing the benefit to cost ratio. Therapeutic decisions must be taken by attending physicians, who should collaborate with the nutrition support team. "All-in-One" bags are generally preferred for PN in hospitals and may be industrially manufactured, industrially manufactured with the necessity to add micronutrients, or be prepared "on-demand" within or outside the hospital according to a standardised or individual composition and under consideration of sterile and aseptic conditions. A standardised procedure should be established for introduction and advancement of enteral or oral nutrition. Home PN may be indicated if the expected duration of when PN exceeds 4 weeks. Home PN is a well established method for providing long-term PN, which should be indicated by the attending physician and be reviewed by the nutrition support team. The care of home PN patients should be standardised whenever possible. The indication for home PN should be regularly reviewed during the course of PN.
肠外营养(PN)应标准化以确保质量并减少并发症,且应尽可能在与专业营养支持团队协商后进行。所有医院都应组建跨学科营养支持团队,因为这能提高PN实施的有效性和效率。该团队的任务包括提高护理质量以及提升效益成本比。治疗决策必须由主治医生做出,其应与营养支持团队协作。在医院中,PN通常更倾向于使用“全合一”袋,其可以是工业生产的、工业生产但需要添加微量营养素的,或者根据标准化或个体化配方并考虑无菌和无菌条件在医院内或医院外“按需”配制。应建立肠内或口服营养引入和推进的标准化程序。如果预计PN持续时间超过4周,则可能需要家庭PN。家庭PN是提供长期PN的成熟方法,应由主治医生开具,并由营养支持团队进行评估。应尽可能对家庭PN患者的护理进行标准化。在PN过程中应定期复查家庭PN的指征。