Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
Department of Pharmacy, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
Nutrients. 2024 Feb 5;16(3):457. doi: 10.3390/nu16030457.
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.
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。