Home Parenteral Nutrition in Patients with Intestinal Failure: Possible Undetected Complications

Nutrients. 2019 Mar 9;11(3):581. doi: 10.3390/nu11030581.

Abstract

Background: Septic pulmonary embolism (SPE) may be a frequently undetected complication of central venous catheter (CVC)-related bloodstream infections (CRBSIs).

Materials and methods: The incidence of SPE was evaluated in a cohort of non-oncological patients on home parenteral nutrition (HPN) who were hospitalized for a CRBSI from January 2013 to December 2017. The main clinical, microbiological, and radiological features and the therapeutic approach were also described.

Results: Twenty-three infections over 51,563 days of HPN therapy were observed, corresponding to an infection rate of 0.45/1000. In 10 out of the 23 cases (43.5%), pulmonary lesions compatible with SPE were identified.

Conclusion: Our results demonstrated that a CRBSI can produce asymptomatic SPE with lung infiltrates in 43.5% of the cases, suggesting the need to check for secondary lung infections to choose the most appropriate antimicrobial therapy.

Keywords: central venous catheter related bloodstream infection; home parenteral nutrition; parenteral nutrition; septic pulmonary embolism.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / drug therapy
  • Bacterial Infections / microbiology*
  • Catheter-Related Infections / drug therapy
  • Catheter-Related Infections / microbiology*
  • Cohort Studies
  • Female
  • Humans
  • Intestinal Diseases / therapy*
  • Male
  • Middle Aged
  • Parenteral Nutrition, Home / adverse effects*
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / etiology*
  • Retrospective Studies
  • Young Adult

Substances

  • Anti-Bacterial Agents