Artificial nutrition in Italy. The RENA study group data

A. Paccagnella, G. Simini, M. Zanello, M. Braga, G. Toigo, P. Dionigi, C. Panella, D. Radrizzani, F. Bozzetti, C. Salis, A. Palozzo, A. Camata, F. Michieletto

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Abstract

Objective: To understand the criteria followed by the Italian Nutrition Support Teams (NST), to investigate their nutritional program with particular emphasis on monitoring of patients, malnutrition, and detection of nutrition-related complications, Methods. 1120 patients, studied by physicians of the Italian Society of Parenteral and Enteral Nutrition (SINPE), are reported. 200 from the medical group (MG), 1O7 from the perioperative group (BASG), 398 from the after surgery group (ASG) and 415 from the intensive care group (ICG). Results: The mean duration of artificial nutrition (AN) was 18 ± 15 days (MG: 24 ± 17; BASG: 18 ± 13; ASG: 16 ± 14; ICG: 17 ± 13) (p <0.001), with an energy intake of 32.8 ± 10.5 kcal/day. Malnutrition nutrition represents the major indication for nutritional treatment (56.7%). TPN, which was carried out in 649 patients (58.8%), was also administered to 29.2% of subjects with a working gut. Out of 1120 subjects studied, 766 (68.3%) received a single type of AN. The reason for the first variation was clinical need (77.7%) and/or AN complications (6.3%). Mean body weight decreased (p <0.001), while plasma transferrin (p <0.05) and total lymphocytes (p <0.001) increased. No significant variations were reported regarding serum albumin. Technical and metabolic complications mainly occurred in the MG (p <0.005: MG vs. surgical groups, and ICG), while septic (p = n.s.: ICG vs. MG; p <0.01: ICG vs. BASG and ASG) and functional (p <0.001: ICG vs. MG, BASG, and ASG) complications arose in ICG patients. Conclusions: Despite previous studies which had reported a discrepancy between clinical practice (i.e. intestinal function, energy need etc.) and standard guidelines, an inappropriate administration of nutritional support is still reported for a large group of patients. This study confirms the need for educational training programs to optimize the clinical and economic approach to nutritional therapy.

Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalRivista Italiana di Nutrizione Parenterale ed Enterale
Volume16
Issue number1
Publication statusPublished - 1998

Keywords

  • Complications
  • Enteral nutrition
  • Epidemiology
  • Malnutrition
  • Parenteral nutrition

ASJC Scopus subject areas

  • Food Science
  • Anatomy
  • Critical Care and Intensive Care Medicine
  • Nutrition and Dietetics

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    Paccagnella, A., Simini, G., Zanello, M., Braga, M., Toigo, G., Dionigi, P., Panella, C., Radrizzani, D., Bozzetti, F., Salis, C., Palozzo, A., Camata, A., & Michieletto, F. (1998). Artificial nutrition in Italy. The RENA study group data. Rivista Italiana di Nutrizione Parenterale ed Enterale, 16(1), 1-13.