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Clinical nutrition, enteral and parenteral nutrition

Composition of personalized and standard nutritional mixtures in patients on home parenteral nutrition

European Journal of Clinical Nutrition volume 68, pages 433–436 (2014)Cite this article

Subjects

Abstract

Background/objectives:

The compounding of personalized parenteral nutrition mixtures (PPNMs) for home parenteral nutrition (HPN) gives the possibility to better satisfy nutritional requirements for patients in selected clinical conditions. The objective of this study was to compare the composition of PPNMs prescribed in selected cases, by a practitioner nutritionist, with that of industrially manufactured standard parenteral nutrition mixtures (SPNMs).

Subjects/methods:

Two hundred and ninety-eight patients (151 men, 147 women, aged 17–87 years) on HPN, followed up in 2011 at our Center, were retrospectively recruited.

Results:

Industrially manufactured SPNMs were prescribed in 230 (77.2%) patients, whereas compounded PPNMs were prescribed in 68 (22.8%). Formulation of PPNMs, adjusted for body weight, did not significantly differ from SPNMs as regards total daily calorie amount, but was significantly different as far as nutrient composition is concerned (P<0.01). Analysis on the daily amount of nutrients per kg of body weight and per patient disease showed that 16/34 (47%) benign chronic intestinal failure (CIF) patients, 47/233 (20%) cancer patients and 5/31 (16%) patients grouped as ‘having other diseases’ needed personalized mixtures (in PPNMs 4–9 nutrients were significantly different from those in SPNMs). Moreover, in CIF patients receiving PPNMs, frequent changes in the formulation (mean 6 times per year, range 1–28) were necessary.

Conclusions:

Our data suggest that, presently, PPNMs cannot be completely replaced by SPNMs owing to special needs in macro and/or micronutrients of some patients and/or the necessity of frequent changes in the nutritional mixture composition, at least until stabilization of clinical and metabolic conditions.

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Acknowledgements

All authors participated in the work and contributed to the acquisition of data, its analysis and interpretation, to drafting the article, critically revising it for intellectual content; moreover, they approve and take public responsibility of the version to be published. IR and SC contributed equally to the work and supervised all the different tasks. We thank Mrs Adelaide Soreca for her support in organizing and coordinating the fieldwork in the Home Artificial Nutrition Unit and Dr Maurizio Iervolino together with Dr Gabriella Negro for the valuable laboratory support. Finally, we thank Mrs Laurajean Carbonaro for the English revision of the manuscript.

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Author notes

  1. C Scanzano and R Iacone: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Clinical Medicine and Surgery, Home Artificial Nutrition Unit, Internal Medicine and Clinical Nutrition Section, ‘Federico II’ University Hospital, Naples, Italy

    C Scanzano, R Iacone, L Alfonsi, M R Galeotalanza, D Sgambati, E Pastore, A D'Isanto, F Fierro, F Contaldo & L Santarpia

Authors
  1. C Scanzano
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  2. R Iacone
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  3. L Alfonsi
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  4. M R Galeotalanza
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  5. D Sgambati
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  6. E Pastore
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  7. A D'Isanto
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  8. F Fierro
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  9. F Contaldo
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  10. L Santarpia
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Corresponding authors

Correspondence to C Scanzano or R Iacone.

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Scanzano, C., Iacone, R., Alfonsi, L. et al. Composition of personalized and standard nutritional mixtures in patients on home parenteral nutrition. Eur J Clin Nutr 68, 433–436 (2014). https://doi.org/10.1038/ejcn.2014.10

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