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A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
Published on: September 20, 2019
Gastroenterology - Guidelines on Parenteral Nutrition, Chapter 15
R J Schulz1, S C Bischoff, B Koletzko
1Clinic for Geriatrics, St. Marien-Hospital, Cologne, Germany.
German Medical Science : GMS E-Journal
|January 6, 2010
Summary
Parenteral nutrition (PN) is crucial for inflammatory bowel diseases when enteral nutrition fails, requiring specific macronutrient compositions. For pancreatitis, PN is reserved for severe cases or complications, with careful monitoring of energy and nutrient levels.
Area of Science:
- Gastroenterology
- Clinical Nutrition
- Internal Medicine
Background:
- Parenteral nutrition (PN) is a vital supportive therapy for patients with inflammatory bowel diseases (IBD) like Crohn's disease and ulcerative colitis when enteral nutrition is not feasible.
- In severe acute pancreatitis, PN is indicated when enteral nutrition is not tolerated, particularly in cases of complications such as pseudocysts or fistulae.
Purpose of the Study:
- To outline the indications and composition of parenteral nutrition in inflammatory bowel diseases.
- To define the role and nutritional considerations of parenteral nutrition in acute pancreatitis.
Main Methods:
- Review of current guidelines and literature on the use of PN in IBD and pancreatitis.
- Analysis of recommended macronutrient distribution (carbohydrates, lipids, amino acids) and micronutrient supplementation for PN in these conditions.
Main Results:
- PN in IBD requires specific macronutrient ratios (55-60% carbohydrates, 25-30% lipids, 10-15% amino acids) and addresses malnutrition, including deficiencies in minerals and vitamins.
- In acute pancreatitis, PN is recommended after 5 days if enteral nutrition is not possible, avoiding routine use in mild cases due to cost and infection risk. Energy needs are 25-35 kcal/kg/day, with glucose, amino acids, and potentially glutamine supplementation.
Conclusions:
- PN is an essential tool for managing malnutrition in IBD and selected cases of pancreatitis, with tailored formulations and careful patient selection.
- Appropriate PN administration, including monitoring and specific composition, is critical for optimizing outcomes in patients with IBD and acute pancreatitis.
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