Komplikacije kućne totalne parentalne prehrane

master's thesis

• Title (english): Complication of home total parental nutrition
• Author: Gordana Bukovina
• Mentor: Sanja Kolaček (mentor)
• Committee member: Jasminka Stepan Giljević (predsjednik povjerenstva)
• Committee member: Sanja Kolaček (član povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2014-09-30, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Nursing

Abstract

Cilj: Cilj ovog istraživanja bio je utvrditi učestalost infekcija povezanih s centralnim venskim kateterom (CVK) u bolesnika na parenteralnoj prehrani u Klinici za dječje bolesti Zagreb u periodu od 24 godine, s posebnim naglaskom na kućnu parenteralnu prehranu.
----- Metode: Retrospektivno su analizirani podaci sve djece na parenteralnoj prehrani (N= 78) liječene u našem centru u periodu od 1989-2013. godine.
----- Rezultati: Parenteralna prehrana uvedena je u srednjoj dobi of 1,2 godine (raspon od 6 dana-17,6 godina), ukupno je bilo 45 dječaka i 33 djevojčice. Od 78 bolesnika njih 15 (19.2%) primalo je kućnu parenteralnu prehranu nakon otpusta iz bolnice. Ukupno je upotrebljeno 107 CVK (prosječno1,37/bolesniku). Ukupno vrijeme CVK iznosi 23 880 dana odnosno 232,2 dana/CVK. Tijekom promatranog razdoblja zabilježeno je 46 sepsi uzrokovanih CVK (1,9/1000 dana parenteralne prehrane).
Na kućnoj parenteralnoj prehrani broj septičkih komplikacija značajno je manji u odnosu na bolničku ( 0,85/1000 vs 5,8/1000 dana parenteralne prehrane; p < 0.001). Ukupno 17 centralnih venskih katetera izvađeno je zbog sepsi uzrokovanih CVK.
Tijekom navedenog razdoblja od komplikacija parenteralne prehrane umrlo je ukupno četvero djece (5,1% ; 0,17 smrtnih ishoda na 1000 dana parenteralne prehrane). Dvoje djece umrlo je od posljedica sepse (jedno na kućnoj i jedno na bolničkoj parenteralnoj prehrani). Drugo dvoje djece umrlo je od zatajenja jetre uzrokovanog parenteralnom prehranom.
----- Zaključak: U zaključku možemo reći da je učestalost infekcija povezanih s CVK izrazito niska i u bolničkoj i kućnoj parenteralnoj prehrani čemu doprinosi dobro medicinsko zbrinjavanje i sestrinska skrb ovih bolesnika.

Abstract (english)

Background & aims: The aim was to assess the rate of central venous catheter (CVC) related complication, mostly sepsis in patients on parenteral nutrition (PN) at our hospital center during a period of 24 years with special emphasizes on hom PN (HPN).
----- Methods: Data on all children who received PN for more than 4 weeks (n = 78) in our tertiary hospital center during the period of 24 years (from 1989-2013), were retrospectively analyzed.
----- Results: The mean age at the time of introducing the PN was 1.2 years (range 6 days to 17.6 years), male/female ratio 45/33. Out of these 78 patients, 15 (19.2%) patients continued HPN after discharge from the hospital. Altogether 107 CVCs were used (mean 1.37 per patient) and total CVC time was 23,880 days, which makes 232.2 days per CVC. During the study period, there were 46 CVC related sepsis episodes (1.9/1000 days of PN). Total number of septic episodes was significantly lower in HPN compared to hospital PN (0.85/1000 vs. 5.8/1000 days of PN; P < 0.001). Septic episodes led to removal of 17 (15.9) CVCs. Althogheter 4 (5.1%) patients died due to PN related complication (0,17 deaths on 1000 PN days); two patients from CVC related sepsis (one on HPN and one at hospital) and two patients died due to intestinal failure associated liver disease (IFALD).
----- Conclusion: The rate of CVC related sepsis in our PN cohort was exceptionally low in both hospital and home setting indication good medical management and nursing care.

• Keywords: centralni venski kateter; parenteralna prehrana; djeca
• Keywords (english): central venous catheter; parenteral nutrition; children
• Language: croatian
• URN:NBN: urn:nbn:hr:105:559847
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-11-03 13:25:13