Subcutaneous edema as a potential cause of catheter failure in older inpatients receiving peripheral parenteral nutrition.

IF 1.9 Q3 PHARMACOLOGY & PHARMACY Drug Discoveries and Therapeutics Pub Date : 2024-07-09 Epub Date: 2024-06-15 DOI:10.5582/ddt.2024.01029
Motoko Kitada, Shigeo Yamamura, Etsuro Hori
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Abstract

Malnutrition is a common problem among hospitalized older patients. Peripheral parenteral nutrition (PN) can improve patient outcomes but can also lead to complications that affect future treatment. Older inpatients, in particular, are expected to be prone to these catheter-related complications. However, the impact of peripheral PN on older inpatients has been rarely investigated. In the current study, the impact of PN on short peripheral catheters (SPCs) was evaluated by comparing signs and symptoms at the time of catheter removal between 22 patients with PN and 27 without. In addition to external clinical assessment, sonographic investigations of the SPC site were performed. The prevalence of external signs and symptoms of complications was similar between the patients (all P > 0.05). However, subcutaneous edema was found by ultrasound in > 80% of patients with PN, compared with 55.6% of those without PN (P = 0.051). Unlike cases without PN, all patients with PN who presented with external signs and symptoms developed subcutaneous edema (P = 0.022). Multivariate analysis demonstrated that administration of PN was independently associated with subcutaneous edema (adjusted odds ratio = 6.88, 95% confidence interval = 1.083-75.486, P = 0.040). For several decades, phlebitis has been the primary focus of complications related to peripheral PN in clinical settings. However, our results imply that peripheral PN causes subcutaneous edema, which can lead to catheter failure in older inpatients. This study contributes to understanding the etiology of catheter failure during peripheral PN in this population.

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皮下水肿是导致接受外周肠外营养的老年住院患者导管失效的潜在原因。
营养不良是住院老年患者的常见问题。外周肠外营养(PN)可以改善患者的预后,但也可能导致影响未来治疗的并发症。老年住院患者尤其容易出现这些与导管相关的并发症。然而,外周 PN 对老年住院患者的影响却鲜有研究。在当前的研究中,通过比较 22 名有 PN 患者和 27 名无 PN 患者拔除导管时的体征和症状,评估了 PN 对短外周导管 (SPC) 的影响。除外部临床评估外,还对 SPC部位进行了超声检查。不同患者的并发症外部体征和症状发生率相似(均为 P > 0.05)。然而,超声波检查发现皮下水肿的 PN 患者超过 80%,而无 PN 患者为 55.6%(P = 0.051)。与无 PN 的病例不同,所有出现外部症状和体征的 PN 患者都出现了皮下水肿(P = 0.022)。多变量分析表明,使用 PN 与皮下水肿密切相关(调整赔率 = 6.88,95% 置信区间 = 1.083-75.486,P = 0.040)。几十年来,静脉炎一直是临床上外周静脉输液并发症的主要病因。然而,我们的研究结果表明,外周静脉输液会引起皮下水肿,从而导致老年住院患者导管失效。这项研究有助于了解老年患者外周静脉输液过程中导管失效的病因。
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来源期刊
Drug Discoveries and Therapeutics
Drug Discoveries and Therapeutics PHARMACOLOGY & PHARMACY-
CiteScore
3.20
自引率
3.20%
发文量
51
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