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家用肠外营养用即用型多腔袋在晚期癌症患者中的应用:一项单中心前瞻性研究。

Ready-to-Use Multichamber Bags in Home Parenteral Nutrition for Patients with Advanced Cancer: A Single-Center Prospective Study.

机构信息

Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.

Department of Pharmacy, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.

出版信息

Nutrients. 2024 Feb 5;16(3):457. doi: 10.3390/nu16030457.

DOI:10.3390/nu16030457
PMID:38337741
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10856902/
Abstract

Home parenteral nutrition (HPN) is increasingly prescribed for patients with advanced cancer. This therapy improves free-fat mass, quality of life and survival, but it is not free from complications, especially catheter-related bloodstream infections (CRBSIs). The use of commercial multichamber bags in HPN has not been extensively explored in oncologic patients and their association with complications is not well known. In this prospective cohort study, we included 130 patients with advanced cancer and HPN. We compared the effects of individual compounded bags (n = 87) vs. commercial multichamber bags (n = 43) on complications. There were no differences in any complication, including thrombosis ( > 0.05). There were 0.28 episodes of CRBSI per 1000 catheter days in the individual compounded bag group and 0.21 in the multichamber bag group ( > 0.05). A total of 34 patients were weaned off HPN, 22 with individual bags and 12 with multichamber bags ( = 0.749). Regarding survival when on HPN, the group with individual bags showed a median of 98 days (95% CI of 49-147), whereas those with multichamber bags showed a median of 88 days (95% CI of 43-133 ( = 0.913)). In conclusion, commercial multichamber bags for HPN in patients with advanced cancer are non-inferior when compared to individual compounded bags in terms of complications.

摘要

家庭肠外营养(HPN)越来越多地用于治疗晚期癌症患者。这种治疗方法可以增加游离脂肪量、提高生活质量并延长生存期,但它并非没有并发症,尤其是导管相关血流感染(CRBSI)。在肿瘤患者中,尚未广泛探索使用商业多腔袋进行 HPN,其与并发症的关系也不为人知。在这项前瞻性队列研究中,我们纳入了 130 名患有晚期癌症和 HPN 的患者。我们比较了个体复合袋(n = 87)与商业多腔袋(n = 43)对并发症的影响。在任何并发症方面,包括血栓形成(>0.05),都没有差异。在个体复合袋组中,每 1000 个导管日发生 0.28 次 CRBSI,而在多腔袋组中为 0.21 次(>0.05)。共有 34 名患者停止接受 HPN,其中 22 名使用个体袋,12 名使用多腔袋(=0.749)。关于接受 HPN 时的生存情况,使用个体袋的患者中位生存时间为 98 天(95%CI:49-147),而使用多腔袋的患者中位生存时间为 88 天(95%CI:43-133)(=0.913)。总之,与个体复合袋相比,商业多腔袋用于晚期癌症患者的 HPN 在并发症方面不劣于后者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2cd/10856902/dc4473b1bc8c/nutrients-16-00457-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2cd/10856902/c2911cbd57fc/nutrients-16-00457-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2cd/10856902/dc4473b1bc8c/nutrients-16-00457-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2cd/10856902/c2911cbd57fc/nutrients-16-00457-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2cd/10856902/dc4473b1bc8c/nutrients-16-00457-g002.jpg

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本文引用的文献

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Nutrients. 2023 May 29;15(11):2531. doi: 10.3390/nu15112531.
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The Rate of Discontinuing Ready-to-Use Multi-Chamber Bag Parenteral Nutrition Secondary to High Serum Electrolyte Levels.因血清电解质水平高而停用即用型多腔袋肠外营养的发生率。
Hosp Pharm. 2023 Jun;58(3):263-271. doi: 10.1177/00185787221133711. Epub 2022 Nov 13.
3
Association between Karnofsky performance status and outcomes in cancer patients on home parenteral nutrition.
癌症患者居家肠外营养时卡氏功能状态与预后的关联
Clin Nutr ESPEN. 2023 Apr;54:211-214. doi: 10.1016/j.clnesp.2023.01.020. Epub 2023 Jan 24.
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Cost-Effectiveness Analyses of Home Parenteral Nutrition for Incurable Gastrointestinal Cancer Patients.不可治愈的胃肠道癌症患者家庭肠内营养的成本效益分析
Front Oncol. 2022 May 18;12:858712. doi: 10.3389/fonc.2022.858712. eCollection 2022.
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SINPE Position Paper on the use of home parenteral nutrition in cancer patients.SINPE关于癌症患者家庭肠外营养应用的立场文件。
Nutrition. 2022 Mar;95:111578. doi: 10.1016/j.nut.2021.111578. Epub 2022 Jan 10.
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ESPEN practical guideline: Clinical Nutrition in cancer.ESPEN 实践指南:癌症患者的临床营养。
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