Infectious complications associated with parenteral nutrition in intensive care unit and non-intensive care unit patients

• Autor(a) principal: Comerlato, Pedro Henrique
• Data de Publicação: 2020
• Outros Autores: Stefani, Joel, Viana, Marina Verçoza, Viana, Luciana Verçoza
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRGS
• Texto Completo: http://hdl.handle.net/10183/255514
• topic: Infecção hospitalar; Nutrição parenteral; Unidades de terapia intensiva; Cateteres venosos centrais; Parenteral nutrition; Catheter; Central venous catheter; CLABSI; Hospital-acquired infection

Introduction: Malnutrition is associated with an increased risk of complications in hospi- talized patients, and parenteral nutrition (PN) is used when oral or enteral feeding is not possible. This study aimed at analyzing associations between PN characteristics and infec- tious complications in hospitalized patients. Material and methods: This was a retrospective cohort study conducted in a tertiarycare university hospital. Data from consecutive adult patients submitted to PN (January 2016 to December 2017; ICU and ward) were reviewed by means of an electronic database. Patient’s clinical characteristics, PN prescription and catheter insertion procedure data were extracted and analyzed. The main outcome was the development of central line–associated bloodstream infection (CLABSI). The secondary outcomes were other infectious complica- tions and mortality, as well as factors associated with CLABSI. Results: We analyzed 165 patients and 247 catheters used for parenteral nutrition infusion. The CLABSI rate was 6.47 per 1000 catheter-days. In the univariable analysis, CLABSI was associated with longer hospitalization time, longer PN time, longer catheter time, catheter insertion performed by a surgeon or a surgical resident, and procedures performed outside the ICU. In an extended time-dependent Cox regression, no variable was associated with a higher risk of CLABSI, and additional PN days did not increase the rate of CLABSI. The overall mortality rate was 24.8%. Only the patients’ comorbidity index was associated with death in the multivariable analysis.