Adult total parenteral nutrition at Auckland City Hospital: a 6-year review

To summarise and evaluate data on the use of total parenteral nutrition (TPN) and associated septic complications at Auckland City Hospital (Auckland, New Zealand) over a 6-year period beginning with appointment of a specialist TPN nurse.

For each adult patient requiring TPN on an inpatient basis (excluding those in critical care) between January 1998 and December 2003 demographic data, reason for TPN requirement, number of days of TPN administration, type of central venous line used for administration, and frequency of infectious complications were collected prospectively.

498 episodes of TPN were recorded in 484 patients (202 male, median age 60, range 15-89 y). Median duration of TPN administration was 11 (range 1-326) d. Over the 6-year period the number of episodes of TPN per year did not change significantly while median duration of TPN decreased from 14.5 d in 1998 to 8 d in 2003 (p<0.0001). Paralytic ileus following abdominal surgery was the predominant indication for TPN. After 1998, the rate of catheter-related bloodstream infections stabilised at 2 per 1000 TPN days.

These results provide a benchmark for infection rates associated with administration of TPN managed by a Nutrition Support Team in a New Zealand tertiary care hospital.