1045

Abstract

Introduction: The aim of this study was to evaluate the impact of different parenteral nutrition delivery systems in critically ill and malnourished patients upon the time spend at the intensive care unit (ICU) and at the hospital. Hypothesis: Parenteral nutrition (PN) is provided to patients in several situations when the gastrointestinal tract is either non functional or when its absorptive capacity is impaired. It is an essential nutritional therapy but that has been associated with numerous problems including bloodstream infections (BSI). A recent study demonstrated that the delivery system can affect the incidence of BSI (Pontes-Arruda et al, JPEN 2012). Therefore, the PN delivery system may also have impact over other outcomes, such as time at the ICU and time of hospitalization. Methods: This was a prospective, international, multicenter, randomized and open-label study that included patients either moderately or severely malnourished and using 3-in-1 PN (containing lipids, aminoacids and dextrose). Patients were randomized to receive their PN using either a ready-to-use and multichamber bag (MCB) or a compounded PN (COM) (trial registration NCT#00798681). Baseline characteristics were collected as well as ICU and hospital days. Results: 316 patients were evaluated,156 in the MCB group and 160 in the COM group, all either moderately or severely malnourished in accordance with the subjective global assessment(SGA). Demographic characteristics of the patients in the two groups such as age; APACHE II score and SOFA score upon admission was considered adequately bal1anced. Both the time at the ICU and at the hospital was evaluated as statistically different. The median hospital days was 15 (13-21) and 18 (14-24) (p=.038); and median ICU days was 8 (6-11) and 11 (7-14) (p=.027) (all MCB vs. COM). Conclusions: The type of delivery system can produce a relevant impact upon the time malnourished and critically ill patients in need of PN spend both at the ICU and at the hospital, which can be translated into an important financial burden associated with PN.