Scanzano C, Iacone R, Alfonsi L, Galeotalanza M R, Sgambati D, Pastore E, D'Isanto A, Fierro F, Contaldo F, Santarpia L
Home Artificial Nutrition Unit, Internal Medicine and Clinical Nutrition Section, Department of Clinical Medicine and Surgery, 'Federico II' University Hospital, Naples, Italy.
Eur J Clin Nutr. 2014 Apr;68(4):433-6. doi: 10.1038/ejcn.2014.10. Epub 2014 Feb 12.
BACKGROUND/OBJECTIVES: The compounding of personalized parenteral nutrition mixtures (PPNMs) for home parenteral nutrition (HPN) gives the possibility to better satisfy nutritional requirements for patients in selected clinical conditions. The objective of this study was to compare the composition of PPNMs prescribed in selected cases, by a practitioner nutritionist, with that of industrially manufactured standard parenteral nutrition mixtures (SPNMs).
SUBJECTS/METHODS: Two hundred and ninety-eight patients (151 men, 147 women, aged 17-87 years) on HPN, followed up in 2011 at our Center, were retrospectively recruited.
Industrially manufactured SPNMs were prescribed in 230 (77.2%) patients, whereas compounded PPNMs were prescribed in 68 (22.8%). Formulation of PPNMs, adjusted for body weight, did not significantly differ from SPNMs as regards total daily calorie amount, but was significantly different as far as nutrient composition is concerned (P<0.01). Analysis on the daily amount of nutrients per kg of body weight and per patient disease showed that 16/34 (47%) benign chronic intestinal failure (CIF) patients, 47/233 (20%) cancer patients and 5/31 (16%) patients grouped as 'having other diseases' needed personalized mixtures (in PPNMs 4-9 nutrients were significantly different from those in SPNMs). Moreover, in CIF patients receiving PPNMs, frequent changes in the formulation (mean 6 times per year, range 1-28) were necessary.
Our data suggest that, presently, PPNMs cannot be completely replaced by SPNMs owing to special needs in macro and/or micronutrients of some patients and/or the necessity of frequent changes in the nutritional mixture composition, at least until stabilization of clinical and metabolic conditions.
背景/目的：为家庭肠外营养（HPN）配制个性化肠外营养混合液（PPNM）能够更好地满足特定临床情况下患者的营养需求。本研究的目的是比较营养科医生为特定病例开具的PPNM与工业化生产的标准肠外营养混合液（SPNM）的成分。
对象/方法：回顾性招募了2011年在我们中心接受随访的298例接受HPN的患者（151例男性，147例女性，年龄17 - 87岁）。
230例（77.2%）患者使用工业化生产的SPNM，而68例（22.8%）患者使用配制的PPNM。按体重调整后的PPNM配方，在每日总热量方面与SPNM无显著差异，但在营养成分方面有显著差异（P<0.01）。对每千克体重和每位患者疾病的每日营养素量进行分析表明，16/34（47%）例良性慢性肠衰竭（CIF）患者、47/233（20%）例癌症患者和5/31（16%）例“患有其他疾病”的患者需要个性化混合液（PPNM中有4 - 9种营养素与SPNM有显著差异）。此外，接受PPNM的CIF患者需要频繁改变配方（平均每年6次，范围1 - 28次）。
我们的数据表明，目前由于部分患者对宏量和/或微量营养素的特殊需求以及营养混合液成分需要频繁改变，至少在临床和代谢状况稳定之前，PPNM不能完全被SPNM取代。
