Clinical Efficacy and Safety of Parenteral Nutrition in Adolescent Girls with Anorexia Nervosa

A. Diamanti, M. S. Basso, M. Castro, G. Bianco, E. Ciacco, A. Calce, A. M. Caramadre, C. Noto, M. Gambarara

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose: Anorexia nervosa (AN) is a common chronic disorder characterized by severe malnutrition and psychological disturbances. Parenteral nutrition (PN) is not usually used in nutritional rehabilitation of AN. The aim of our study was to retrospectively evaluate the indications, clinical efficacy, and safety of PN as assessed by short- and long-term outcomes in AN inpatient girls. Methods: During the last 10 years a total of 198 inpatients were included in our study: 104 (53%) received oral and parenteral refeeding (group A) and 94 (47%) oral refeeding alone (group B). For each nutritional treatment, clinical efficacy was evaluated by short- and long-term outcomes, and safety was assessed by complication rate. Results: Short-term outcome assessment indicated weekly weight gain and maximum caloric intake to be higher in PN-treated patients. Long-term outcome evaluation showed rehospitalization and recovery rate to be similar in the two groups, but failure of first nutritional rehabilitation requiring PN significantly greater in group B (17.5%) than in group A (3%) (p = .01). The number of complications was significantly higher in group A than in group B (p = .004), although all complications resolved. Conclusion: Among all nutritional rehabilitation strategies, PN offers an alternative and safe way to successfully treat AN patients. Presence of clinical complications and reduced compliance with individual, group, and family therapy seem to be the main indications for PN, as it promptly improves nutritional status. At pediatric and adolescent ages, psychological disturbances can also contraindicate the use of enteral nutrition, and therefore represent an additional indication for PN.

Original languageEnglish
Pages (from-to)111-118
Number of pages8
JournalJournal of Adolescent Health
Volume42
Issue number2
DOIs
Publication statusPublished - Feb 2008

Fingerprint

Anorexia Nervosa
Parenteral Nutrition
Safety
Rehabilitation
Inpatients
Psychology
Family Therapy
Enteral Nutrition
Group Psychotherapy
Energy Intake
Nutritional Status
Malnutrition
Weight Gain
Outcome Assessment (Health Care)
Pediatrics

Keywords

  • Adolescents
  • Anorexia nervosa
  • Parenteral nutrition

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Clinical Efficacy and Safety of Parenteral Nutrition in Adolescent Girls with Anorexia Nervosa. / Diamanti, A.; Basso, M. S.; Castro, M.; Bianco, G.; Ciacco, E.; Calce, A.; Caramadre, A. M.; Noto, C.; Gambarara, M.

In: Journal of Adolescent Health, Vol. 42, No. 2, 02.2008, p. 111-118.

Research output: Contribution to journalArticle

Diamanti, A, Basso, MS, Castro, M, Bianco, G, Ciacco, E, Calce, A, Caramadre, AM, Noto, C & Gambarara, M 2008, 'Clinical Efficacy and Safety of Parenteral Nutrition in Adolescent Girls with Anorexia Nervosa', Journal of Adolescent Health, vol. 42, no. 2, pp. 111-118. https://doi.org/10.1016/j.jadohealth.2007.09.024
Diamanti, A. ; Basso, M. S. ; Castro, M. ; Bianco, G. ; Ciacco, E. ; Calce, A. ; Caramadre, A. M. ; Noto, C. ; Gambarara, M. / Clinical Efficacy and Safety of Parenteral Nutrition in Adolescent Girls with Anorexia Nervosa. In: Journal of Adolescent Health. 2008 ; Vol. 42, No. 2. pp. 111-118.
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AU - Ciacco, E.

AU - Calce, A.

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AB - Purpose: Anorexia nervosa (AN) is a common chronic disorder characterized by severe malnutrition and psychological disturbances. Parenteral nutrition (PN) is not usually used in nutritional rehabilitation of AN. The aim of our study was to retrospectively evaluate the indications, clinical efficacy, and safety of PN as assessed by short- and long-term outcomes in AN inpatient girls. Methods: During the last 10 years a total of 198 inpatients were included in our study: 104 (53%) received oral and parenteral refeeding (group A) and 94 (47%) oral refeeding alone (group B). For each nutritional treatment, clinical efficacy was evaluated by short- and long-term outcomes, and safety was assessed by complication rate. Results: Short-term outcome assessment indicated weekly weight gain and maximum caloric intake to be higher in PN-treated patients. Long-term outcome evaluation showed rehospitalization and recovery rate to be similar in the two groups, but failure of first nutritional rehabilitation requiring PN significantly greater in group B (17.5%) than in group A (3%) (p = .01). The number of complications was significantly higher in group A than in group B (p = .004), although all complications resolved. Conclusion: Among all nutritional rehabilitation strategies, PN offers an alternative and safe way to successfully treat AN patients. Presence of clinical complications and reduced compliance with individual, group, and family therapy seem to be the main indications for PN, as it promptly improves nutritional status. At pediatric and adolescent ages, psychological disturbances can also contraindicate the use of enteral nutrition, and therefore represent an additional indication for PN.

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