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Canadian home parenteral nutrition (HPN) registry: validation and patient outcomes.

https://arctichealth.org/en/permalink/ahliterature127079
Source
JPEN J Parenter Enteral Nutr. 2012 Jul;36(4):407-14
Publication Type
Article
Date
Jul-2012
Author
G. Fernandes
B. Kaila
K N Jeejeebhoy
L. Gramlich
D. Armstrong
J P Allard
Author Affiliation
University Health Network, Toronto General Hospital, Toronto, Ontario, Canada.
Source
JPEN J Parenter Enteral Nutr. 2012 Jul;36(4):407-14
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Bilirubin - blood
Canada
Female
Follow-Up Studies
Hospitalization
Humans
Liver Diseases - etiology - physiopathology
Male
Nutrition Assessment
Parenteral Nutrition, Home - adverse effects - methods
Potassium - blood
Quality of Life
Registries
Treatment Outcome
Abstract
In Canada, there are an estimated 400 home parenteral nutrition (HPN) patients. In 2006, a registry was created to gather patient outcome information. The aim of this study was to validate the registry and report on HPN patient outcomes.
Several demographic, clinical parameters were collected. For the validation, paired t test and intraclass correlation coefficient (ICC) were used to assess agreement between repeat entries. For the outcome report, paired t test was used to assess changes, and survival analysis was performed using the Kaplan-Meier method. Results are expressed as mean ± SEM.
On validation, there was high correlation/agreement (P
PubMed ID
22326909 View in PubMed
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Source
Can J Gastroenterol. 1998 Apr;12(3):201-7
Publication Type
Article
Date
Apr-1998
Author
W. Siriboonkoom
L. Gramlich
Author Affiliation
Department of Medicine, University of Alberta, Edmonton.
Source
Can J Gastroenterol. 1998 Apr;12(3):201-7
Date
Apr-1998
Language
English
Publication Type
Article
Keywords
Alberta - epidemiology
Chronic Disease
Humans
Liver Diseases - complications - diet therapy
Nutrition Assessment
Nutrition Disorders - diagnosis - epidemiology - etiology
Prevalence
Abstract
Malnutrition frequently occurs in patients with chronic liver disease, and may influence both short and long term clinical outcome in these patients. Therefore, nutritional intervention may play an important role in the management of chronic liver disease patients. Recent progress in nutritional assessment, principles of nutrition management and the impact of malnutrition upon the clinical outcome of chronic liver disease are reviewed and summarized. Recommendations on how to manage/prevent malnutrition in these patients will be presented.
PubMed ID
9582545 View in PubMed
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Prescription of trace elements in adults on home parenteral nutrition: current practice based on the Canadian Home Parenteral Nutrition Registry.

https://arctichealth.org/en/permalink/ahliterature119880
Source
JPEN J Parenter Enteral Nutr. 2013 May-Jun;37(3):410-5
Publication Type
Article
Author
R. Abdalian
G. Fernandes
D. Duerksen
K N Jeejeebhoy
S. Whittaker
L. Gramlich
J P Allard
Author Affiliation
North York General Hospital, Toronto, Ontario, Canada.
Source
JPEN J Parenter Enteral Nutr. 2013 May-Jun;37(3):410-5
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada
Chromium - administration & dosage
Copper - administration & dosage
Dietary Supplements
Dose-Response Relationship, Drug
Female
Humans
Iodine - administration & dosage
Male
Manganese - administration & dosage
Middle Aged
Nutritional Status
Parenteral Nutrition, Home - methods - standards
Practice Guidelines as Topic
Registries
Retrospective Studies
Selenium - administration & dosage
Trace Elements - administration & dosage
Zinc - administration & dosage
Abstract
Since the introduction of long-term parenteral nutrition (PN), morbidity due to inadequate replacement or toxicity of routinely administered trace elements has been well described. After decades of experience, much debate still exists about optimal supplementation. In practice, trace elements (TEs) seem to be frequently provided by prescribing an all-inclusive commercial multi-TE admixture with little dosage flexibility.
Our goal was to review TE supplementation practice among 5 PN support centers across Canada, through a retrospective review of the Canadian Home PN Registry.
Baseline demographic, clinical, and biochemical parameters along with information regarding the PN prescription of 135 patients with complete records were retrieved from the registry database collected between 2005 and 2007. TE supplementation prescriptions were compared with recent guidelines as well as between groups of patients with different PN indications and dietary intake status. Consent was signed by all participating patients.
The average daily PN concentrations of TE were as follows: zinc, 8.6 ± 5.5 mg (130.92 ± 84.23 µmol); manganese, 452 ± 184 µg (8.22 ± 3.34 µmol); selenium, 78 ± 45 µg (0.99 ± 0.57 µmol); chromium, 11 ± 5 µg (0.21 ± 0.10 µmol); copper, 0.64 ± 0.35 mg (10.11 ± 5.58 µmol); and iodine, 77 ± 42 µg (0.61 ± 0.33 µmol). The mean daily supplementation of zinc, manganese, copper, and selenium exceeded published recommendations. Patients' underlying anatomy or indication for PN did not significantly influence decisions regarding replacement standards.
Parenteral TE supplementation in Canadian PN programs needs to be reviewed and adjusted according to most current guidelines. This may require a reevaluation of the commercial TE preparations currently available in Canada and potential new products worldwide to avoid oversupplementation and potential toxicity.
PubMed ID
23064256 View in PubMed
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