Abstract

Purpose: Malnutrition often appears in critically ill cancer patients, thus proper nutritional support is essential according to a patient’s condition. The purpose of this study was to evaluate the appropriateness and safety of PN (parenteral nutrition) in critically ill cancer patients.
Materials and Methods: The indications and appropriateness of nutrition support and monitoring along with complications of PN were evaluated based on ASPEN-SCCM guidelines (2009) in hospitalized adult cancer patients in the National Cancer Center Intensive Care Unit from March to August 2010 from electronic medical records, retrospectively.
Results: The percentage of overfeeding more than 120% of caloric requirement at the start of PN was 43.2% (16 pts) among the total population, and an average ratio of less than 80% of caloric requirements was found in 16% (6 pts) among 37 patients. Lipids were supplied in the majority of patients (34 pts, 91.9%), but the supply rates of vitamins (15 pts, 44.1%) and trace elements (12, 37.8%) were relatively low. All the monitoring for PN was performed appropriately in over 80% of patients except for serum triglycerides and serum Mg. For the assessment of complications of PN, hyperglycemia (≥200 mg/dl) presented in 56.8% (21 pts), hepatic enzyme elevations associated with PN were found in 16.2% (6 pts), and catheter infection occurred in 5.4% (2 pts).
Conclusion: PN in critically ill cancer patients was not performed according to guidelines, and some complications occurred related to PN. Therefore, reinforced education of medical team members on the hospital system of nutritional support are needed to appropriately utilize PN in critically ill cancer patients. (SMN 2011;2:26-33)

• Keywords: Parenteral nutrition, Critically ill patients, Nutrition support team