MON-PP009: Frequency and Characteristics of Pump Alarms in Patients on Home Parenteral Nutrition

Abstract

Rationale: Muscle wasting occurs in elderly, long term muscle disuse, malnutrition and a number of other catabolic conditions. Studies showed that the amino acid composition of whey protein is effective in promoting protein synthesis in skeletal muscle, improving accretion and/or slowing down muscle mass loss in patients with wasting syndrome. This study compares amino acid composition of standard and personalized parenteral nutrition mixtures with that of whey protein. Methods: As many as 113 patients (54 men, 59 women, aged 20 89 years) on home parenteral nutrition were retrospectively recruited. Ten types of standard parenteral nutrition mixtures (SPNMs), industrially manufactured, were prescribed in 75 (66%) patients while compounded personalized parenteral nutrition mixtures (PPNMs) in 38 (34%). The amino acid solution in compounding of personalized parenteral nutrition mixtures was Sintamin 10% (Fresenius Kabi). Results: Setting leucine (Leu) and essential amino acids (EAAs) amounts in whey protein at 100% and the usually daily dose of amino acids (AAs) at 1 g/kg body weight (BW), the mean Leu content adjusted for BW was 86% in PPNMs and 57% in SPNMs, while the BW adjusted EAAs content was 111% and 100%, respectively. Conclusion: Synthesis of muscle proteins needs adequate amount of EAAs, particularly of Leu that regulates protein synthesis in skeletal muscle. Although our data are lacking in comparative effectiveness, they suggest that PPNMs, rather than SPNMs, could have a better AAs composition for patients with muscle wasting because this composition tends to be closer to that of whey protein. In conclusion, mixtures for parenteral nutrition with amino acid composition close to that of whey protein could be recommended to be tested in the clinical practice.