Abstract
Introduction: A paediatric parenteral nutrition support team was established in Queen Mary Hospital in November 1998. The team consisted of paediatrician, paediatric surgeon, nurse specialist and pharmacist. Weekly meeting was held to monitor the progress of and complications in children requiring parenteral nutrition (PN). The objectives of this study is to review the complications in patients receiving PN and the impact of a multi-disciplinary PN support team in the paediatric and neonatal intensive care service within a general hospital. Methods: Clinical data on paediatric patients requiring PN from November 1998 to November 2003 were collected prospectively. Number of patients in different clinical areas, duration of and indications for parenteral nutrition were recorded. Route of administrating PN and complications including the incidence of blood stream infection and cholestatic jaundice were analysed Results: Eighty-three children and 383 neonates received PN in the intensive care unit during the study period. The average PN duration was 9 days for paediatric age group and 18 days for neonates. The incidence of PN related cholestasis was 20% in 1999, 21% in 2000, 14% in 2001, 8% in 2002 and 7% in 2003. The incidence of blood stream infection dropped markedly from maximum of 12 episodes per 1000 days of PN in 2000 to 6 episodes per 1000 days of PN in 2003 while the use of central catheter for administrating PN was increased from 70% to 96% during the period. Conclusion: To improve survival and decrease morbidity of sick patients in the intensive care unit, good nutrition support is essential. With a dedicated PN team paying meticulous attention on the delivery of PN, complications can be reduced significantly. The incidence of cholestasis and blood stream infection was closely related. The increased use of central catheters in delivering PN was shown to associate with lower blood stream infection rate.
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