Displaying all 9 publications

Abstract:
Sort:
  1. Roszali MA, Zakaria AN, Mohd Tahir NA
    Clin Nutr ESPEN, 2021 02;41:275-280.
    PMID: 33487276 DOI: 10.1016/j.clnesp.2020.11.023
    BACKGROUND & AIMS: Hyperglycemia is among the common complications of parenteral nutrition (PN) and is often associated with increased mortality despite being treatable. Studies of parenteral nutrition causing hyperglycemia are limited and even available studies lack methodological conduct. This study aimed to evaluate the prevalence, predictors and management of PN-associated hyperglycemia (PN-AH).

    METHODS: A retrospective study was conducted at a tertiary hospital. Patients ≥ 18 years old who received parenteral nutrition from 2015 to 2018 were conveniently selected. The demographic data, diagnosis, clinically relevant data, blood glucose readings and management of hyperglycemia were gathered from electronic medical records.

    RESULTS: Among 300 patients included in the study, 140 (46.7%) reported the PN-AH events. Multivariate logistic regression analysis showed female sex, Malay ethnicity, underlying type 2 diabetes mellitus, liver impairment, elevated pre-PN glucose level > 180 mg/dL and ICU admission were independently associated with hyperglycemia (p 

    Matched MeSH terms: Parenteral Nutrition/adverse effects
  2. Ibrahim NR, Kheng TH, Nasir A, Ramli N, Foo JLK, Syed Alwi SH, et al.
    Arch. Dis. Child. Fetal Neonatal Ed., 2017 May;102(3):F225-F229.
    PMID: 27671836 DOI: 10.1136/archdischild-2015-310246
    OBJECTIVE: To determine whether feeding with 2-hourly or 3-hourly feeding interval reduces the time to achieve full enteral feeding and to compare their outcome in very low birthweight preterm infants.

    DESIGN: Parallel-group randomised controlled trial with a 1:1 allocation ratio.

    SETTING: Two regional tertiary neonatal intensive care units.

    PATIENTS: 150 preterm infants less than 35 weeks gestation with birth weight between 1.0 and 1.5 kg were recruited.

    INTERVENTIONS: Infants were enrolled to either 2-hourly or 3-hourly interval feeding after randomisation. Blinding was not possible due to the nature of the intervention.

    MAIN OUTCOME MEASURES: The primary outcome was time to achieve full enteral feeding (≥100 mL/kg/day). Secondary outcomes include time to regain birth weight, episode of feeding intolerance, peak serum bilirubin levels, duration of phototherapy, episode of necrotising enterocolitis, nosocomial sepsis and gastro-oesophageal reflux.

    RESULTS: 72 infants were available for primary outcome analysis in each group as three were excluded due to death-three deaths in each group. The mean time to full enteral feeding was 11.3 days in the 3-hourly group and 10.2 days in the 2-hourly group (mean difference 1.1 days; 95% CI -0.4 to 2.5; p=0.14). The mean time to regain birth weight was shorter in 3-hourly group (12.9 vs 14.8 days, p=0.04). Other subgroup analyses did not reveal additional significant results. No difference in adverse events was found between the groups.

    CONCLUSION: 3-hourly feeding was comparable with 2-hourly feeding to achieve full enteral feeding without any evidence of increased adverse events.

    TRIAL REGISTRATION NUMBER: ACTRN12611000676910, pre-result.

    Matched MeSH terms: Parenteral Nutrition/adverse effects
  3. Lee WS, Sokol RJ
    J Pediatr, 2015 Sep;167(3):519-26.
    PMID: 26130113 DOI: 10.1016/j.jpeds.2015.05.048
    Matched MeSH terms: Parenteral Nutrition/adverse effects*
  4. Chong PF, Paraidathathu T
    Asia Pac J Clin Nutr, 2013;22(4):548-56.
    PMID: 24231015 DOI: 10.6133/apjcn.2013.22.4.15
    The effectiveness of the Nutrition Support Team (NST) at Hospital Sungai Buloh, a large public hospital in Kuala Lumpur, Malaysia, in optimising parenteral nutrition (PN) has not been evaluated. To evaluate the effects of this NST in optimising patient outcomes, treatment outcomes, and adherence to biochemical monitoring guidelines, two groups of patients, those given PN before (n = 106) NST intervention and those given PN after (n=106) NST intervention, were retrospectively compared. Intervention by the NST significantly reduced metabolic abnormalities, reducing sodium abnormalities from 67% to 44% (p<0.01); potassium abnormalities from 42% to 15% (p<0.01); magnesium abnormalities from 13% to 3% (p<0.05) and phosphate abnormalities from 21% to 9% (p=0.01). Intervention by the NST also significantly reduced the incidence of hypertriglyceridemia from 68% to 45% (p=0.002) and significantly improved adherence to biochemical monitoring guidelines from 46% to 72% (p<0.01). However, the length of hospital stay, patient mortality, and duration of PN were similar in both groups. This study failed to demonstrate that the establishment of a NST gave better outcomes in terms of the common measures of effectiveness. In conclusion, although management by an NST significantly reduced metabolic abnormalities and improved adherence to biochemical monitoring guidelines, the NST did not improve patient mortality rates and length of hospital stay.
    Matched MeSH terms: Parenteral Nutrition/adverse effects*
  5. Cheong SM, Totsu S, Nakanishi H, Uchiyama A, Kusuda S
    J Neonatal Perinatal Med, 2016;9(1):99-105.
    PMID: 27002262 DOI: 10.3233/NPM-16915054
    OBJECTIVE: In order to evaluate safety and usefulness of peripherally inserted double lumen central catheter (PIDLCC) in very low birth weight (VLBW) infants, outcomes of VLBW infants who had PIDLCC was studied.

    SUBJECTIVE: Thirty-nine VLBW infants who were admitted to our NICU in 2013 were retrospectively analyzed.

    RESULTS: Mean birth weight and gestational age was 1042.7 gram and 28.5 weeks, respectively. Total duration of indwelling PIDLCC was 1121 days (mean 28.5+18.2 days) with 85 PIDLCCs used. Dressing at the insertion site was done twice weekly with 10% povidone iodine. Four (10.3% with mean of 48 days) infants had catheter-related blood stream infection (CRBSI), with a 3.57 infection per 1000 catheter-day. The mean for days of PIDLCC in 35 infants without CRBSI was 26.5 days. Organisms isolated were Staphylococcus epidermidis, Staphylococcus aureus and Staphylococcus capitis ureolytic. Our study showed significant difference in the duration of indwelling catheter (p = 0.023) and intraventricular hemorrhage (p = 0.043) between the CRBSI group and non-CRBSI group. Five (12.8%) infants had abnormal thyroid function test, in which two infants required thyroxine supplementation upon discharge. However, duration of PIDLCC and abnormal thyroid function test was not statistically significant (p = 0.218). One (2.5%) infant died (death was not related to CRBSI). There was no serious adverse effects secondary to PIDLCC.

    CONCLUSION: It is concluded that the use and maintenance of PIDLCC is safe for VLBW infants, but close monitoring should be observed to detect early signs of infection.

    Matched MeSH terms: Parenteral Nutrition/adverse effects*
  6. Goh KT
    Ann Acad Med Singap, 1980 Apr;9(2):136-41.
    PMID: 6775577
    257 cases of acute hepatitis B were reported between January 1977 and June 1979. This constituted about one-third of all reported acute viral hepatitis cases in Singapore. The mean annual morbidity and mortality rates per 100,000 was 4.4 and 0.12 respectively. The case-fatality rate was 2.7%. The age-specific morbidity rates were high in the 15-24 and 25-34 years age groups, while the ethnic specific morbidity rate was highest in Indians. The male to female ratio was 4.6: 1. Cases were concentrated in urban and suburban areas with high population density. Three outbreaks, one traced to contaminated needles and syringes, one to contaminated tattoo neeedles, and amongst close contacts, were described. Although parenteral procedures were associated with hepatitis B infection (p < 0.005), non-parenteral or inapparent parenteral mode of transmission probably contributes to a significant extent in the transmission of hepatitis B in Singapore. Studies to determine the role of perinatal transmission, and of vectors, in maintaining the endemicity of the disease, were suggested.
    Matched MeSH terms: Parenteral Nutrition/adverse effects
  7. Habsah H, Zeehaida M, Van Rostenberghe H, Noraida R, Wan Pauzi WI, Fatimah I, et al.
    J Hosp Infect, 2005 Nov;61(3):213-8.
    PMID: 16213372
    Contaminated parenteral nutrition (PN) is an important source of infection in neonates. Many organisms have been reported to cause contamination that results in outbreaks in intensive care units. The objective of this study was to investigate an outbreak caused by Pantoea spp., which contaminates PN, in a neonatal intensive care unit (NICU). This was a descriptive study of an outbreak of sepsis in an NICU of a tertiary teaching hospital in Malaysia. Pantoea spp. infection was detected in eight patients over a three-day period from 24 to 27 January 2004 following the administration of PN. Seven of the eight patients died due to the infection. Extensive environmental samplings for culture were performed. PN solution from the NICU and the pharmacy were also cultured during the outbreak period. Pantoea spp. was isolated from blood cultures of all infected patients, and the unused PN from the pharmacy and the NICU. All the strains of Pantoea spp. had a similar antibiotic susceptibility pattern and biochemical reaction. From the results, we concluded that PN was the source of the outbreak and the contamination may have occurred during its preparation in the pharmacy. A thorough investigation has been carried out and, where possible, corrective measures have been taken to avoid similar outbreaks in the future.
    Matched MeSH terms: Parenteral Nutrition/adverse effects*
  8. Van Rostenberghe H, Noraida R, Wan Pauzi WI, Habsah H, Zeehaida M, Rosliza AR, et al.
    Jpn J Infect Dis, 2006 Apr;59(2):120-1.
    PMID: 16632913
    Pantoea infections are uncommon in humans. Most reports have involved adults or children after thorn injuries. There are only a few reports of systemic infections with Pantoea. This is the first report of the clinical picture of systemic Pantoea spp. infection in neonates as observed during an outbreak in a neonatal intensive care unit caused by infected parenteral nutrition solutions. Even though detected early, the infections had a fulminant course, causing septicemic shock and respiratory failure. Pulmonary disease was prominent and presented mainly as pulmonary hemorrhage and adult respiratory distress syndrome. The organism was sensitive to most antibiotics used in neonatal intensive care units, but the clinical response to antibiotic therapy was poor. The fatality rate was very high: 7 out of 8 infected infants succumbed to the infection (87.5%).
    Matched MeSH terms: Parenteral Nutrition/adverse effects*
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links