Relationship between supplemental parenteral nutrition and nosocomial infection in intensive care unit

Abstract

Objective To explore the relationship between supplemental parenteral nutrition (SPN) and nosocomial infection. Methods A prospective study was conducted from June 2014 to December 2017 in intensive care unit (ICU). Age, gender, serum albumin at admission, severity of disease, length of stay in ICU, nutrition delivery approach, amounts of delivered caloric intake and occurence of nosocomial infection were recorded.Patients were classified into two groups according to nutrition delivery approach-SPN group and enteral nutrition (EN) alone group.Cox analysis were performed to identify the risk factors and assess the independent effect of SPN approach on nosocomial infection in ICU. Results 278 patients were screened and 246 were analysed in our study.Compared with EN alone group, patients delivered by SPN had a higher nosocomial infection rate (35% vs 10%, P<0.001). The SPN group were further divided into two subgroups by initiation timing, which were defined as early-initiation SPN and late-initiation SPN group respectively.Cox regression analysis showed that compared with EN, SPN did not increase the risk of nosocomial infection (relative risk RR=1.10, P=0.84), and delayed SPN was not associated with nosocomial infection (RR=0.75, P=0.42). Risk factors associated with nosocomial infection including acute physiology and chronic health evaluation systemⅡ (APACHE Ⅱ) (RR=1.29, P<0.001), sequential organ failure score (SOFA) (RR=1.25, P=0.003), length of stay in ICU (RR=1.06, P=0.04), mechanical ventilation time (RR=1.45, P<0.001), catheter indwelling time (RR=1.19, P=0.003) and central venous catheter time (RR=1.10, P=0.001). Conclusions SPN does not increase the risk of nosocomial infection in ICU inpatients. Key words: Enteral nutrition; Parenteral nutrition; Nosocomial infection; Intensive care unit