Safety and Efficacy of Subcutaneous Parenteral Nutrition in Older Patients: A Prospective Randomized Multicenter Clinical Trial

JPEN. Journal of Parenteral and Enteral Nutrition
Gary P ZalogaClinimix Subcutaneous Study Group

Abstract

Many patients who cannot tolerate adequate enteral nutrition could benefit from parenteral nutrition support but fail to receive it due to difficult intravenous (IV) access. The objective of this study was to compare the safety and efficacy of subcutaneous (SC) administration of parenteral nutrition with the peripheral IV route. This was a prospective randomized multicenter study of 121 older hospitalized patients. The primary outcome was the composite end point of major local side effects, defined as local edema, blistering, erythema, phlebitis, cellulitis, unbearable pain, or route failure requiring a switch in route. Secondary outcomes were nutrition parameters, biochemical parameters, clinical outcomes, and safety. The SC route (n = 59) was noninferior to the IV route (n = 61) for major local side effects. Major local side effects trended higher in the IV group ( P = .059). Local edema was more common in the SC group ( P < .05), while route failure was more common in the IV group ( P < .001). Nutrition and biochemical parameters, safety, and clinical outcomes were similar between groups. The SC route of nutrient administration was better tolerated than the peripheral IV route. SC administration of parenteral nutrition repre...Continue Reading

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Citations

Jun 8, 2018·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Mary K Russell, Paul E Wischmeyer
Jul 25, 2018·Hospital Pharmacy·Roland N DickersonAnne M Tucker
Feb 15, 2018·JPEN. Journal of Parenteral and Enteral Nutrition·Riccardo CaccialanzaAlessandro Pontes-Arruda
Nov 26, 2020·JPEN. Journal of Parenteral and Enteral Nutrition·Heather H KellerManon Laporte
Jan 12, 2020·International Journal of Antimicrobial Agents·Morgane MailheJean-Christophe Lagier

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