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A technique for evaluating sepsis in TPN patients
JPEN. Journal of Parenteral and Enteral Nutrition
|January 1, 1977
Summary
Diagnosing sepsis from total parenteral nutrition (TPN) involves a novel blood culture technique. Negative results effectively rule out TPN as the sepsis source, aiding clinical decisions.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Nutritional Support
Background:
- Sepsis is a significant risk associated with total parenteral nutrition (TPN).
- Current methods for diagnosing TPN-related sepsis are varied and may lack definitive diagnostic power.
- Fever spikes in patients on TPN necessitate prompt and accurate etiological investigation.
Purpose of the Study:
- To present and evaluate a specific technique for diagnosing sepsis in patients receiving TPN.
- To determine the utility of a modified blood culture method in identifying TPN as a source of sepsis.
Main Methods:
- A technique involving the withdrawal of blood into TPN tubing and solution.
- Subsequent transfer of this blood-infused TPN to three separate blood culture bottles: blood, blood-infusate mixture, and infusate alone.
- Resumption of TPN infusion after sample collection.
Main Results:
- Negative culture results from this method appear to reliably exclude TPN as the source of sepsis.
- Positive results indicate potential contamination but require careful interpretation due to possible sources (blood, catheter, tubing, filter, or solution).
Conclusions:
- This specialized blood culture technique offers a valuable tool for evaluating suspected TPN-associated sepsis.
- Negative findings strongly suggest TPN is not the infectious source, simplifying patient management.
- Positive findings necessitate a thorough investigation of all components within the TPN system.