Nutrición parenteral suplementada en el final de la vida: consideraciones nutricionales y tecnológicas
- Francisco Rivas García 1
- Rafael Giménez Martínez 2
- Margarita López-Viota Gallardo 3
- 1 Ayuntamiento de Guadix
- 2 Departamento de Nutrición y Bromatología. Universidad de Granada
- 3 Departamento de Farmacia y Tecnología Farmacéutica. Universidad de Granada.
ISSN: 2340-9894, 0004-2927
Año de publicación: 2022
Volumen: 63
Número: 4
Páginas: 355-371
Tipo: Artículo
Otras publicaciones en: Ars pharmaceutica
Resumen
Introduction: The end of life (OL) implies a period in which a certain disease or other situation leads to an inexo-rable path towards death. The clinical situation makes the approach to VF very complex, especially in those stages where the parenteral route is the only way to provide nutritional support. Method: A narrative bibliographic review was carried out based on the search in different databases such as Medline, Science Direct and Scopus of all the articles published until March 2021 that show a series of nutritional and technological considerations of supplemented parenteral nutrition (PN) and your possible benefits at EOL. Results: It is necessary to carry out adequate monitoring of FV with PN to determine the importance of adding nutritional supplements, due to their beneficial effects, such as glutamine, arginine, zinc, chromium, citrulline, se-lenium, zinc or coenzyme Q to attenuate the alterations typical of FV and avoid new complications. Also, a series of technological criteria must be considered to guarantee the stability of the NP and its nutrients. Conclusions: The supplemented PN that is administered in the FV involves controlling a series of factors that are involved in its stability. Beneficial actions have been observed with NP supplemented with zinc, selenium, chromi-um and taurine.
Referencias bibliográficas
- Adams ABC of palliative care. The last 48 hours. Br Med J. 1997: 315: 1600-1603.14. Chan RJ, Webster J, Bowers A. End-of-life care pathways for improving outcomes in caring for the dying. Cochrane Database Syst Rev. 2016; 2(2):CD008006. DOI: 10.1002/14651858.CD008006.pub4
- Akatsu H, Manabe T, Kawade Y, et al. Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion. PLoS One. 2020; 15(8):e0237104. DOI: 10.1371/journal.pone.0237104
- Allen LV Jr. Sterile Basics: Intravenous Admixture Preparation Considerations, Part 5: pH Considera-tions. Int J Pharm Compd. 2020; 24(4):305-309.
- ASPEN. Parenteral Nutrition Handbook, Third Edition. 2020.
- Athanasiou C, Hatziantoniou S, Skouroliakou M, Markantonis-Kyroudis S. Assessment of the phy-sicochemical stability of all-in-one parenteral emulsions for neonates according to USP specifications. JPEN. 2014; 38(7):867-72. DOI: 10.1177/0148607113499589
- Barco S, Atema JJ, Coppens M, Serlie MJ, Middeldorp S. Anticoagulants for the prevention and treatment of catheter-related thrombosis in adults and children on parenteral nutrition: a systematic review and critical appraisal. Blood Transfus. 2017; 15(4):369-377. DOI: 10.2450/2016.0031-16
- Berger MM. The 2013 Arvid Wretlind lecture: evolving concepts in parenteral nutrition. Clin Nutr. 2014; 33(4): 563-70. DOI: 10.1016/j.clnu.2014.03.005
- Biesalski HK, Bischoff SC, Boehles HJ, Muehlhoefer A; Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine. Water, electrolytes, vitamins and trace elements - Guidelines on Parenteral Nutrition, Chapter 7. Ger Med Sci. 2009; 7:Doc21. DOI: 10.3205/000080
- Bozzetti F. Parenteral nutrition. Nutrition. 2019; 66:101-107. DOI: 10.1016/j.nut.2019.03.013
- Caccialanza R, Cereda E, Caraccia M, et al. Early 7-day supplemental parenteral nutrition improves body composition and muscle strength in hypophagic cancer patients at nutritional risk. Support Care Cancer. 2019; 27(7): 2497-2506. DOI: 10.1007/s00520-018-4527-0
- Chappuy L, Charroin C, Vételé F, et al. Stability and sterility of parenteral nutrition admixture for pa-tients home care manufactured by the automated compounding BAXA® EM 2400. Ann Pharm Fr. 2013; 71(6):401-9. DOI: 10.1016/j.pharma.2013.08.011
- Cohen CB. Interdisciplinary consultation on the care of the critically ill and dying: the role of one hos-pital ethics committee. Crit Care Med. 1982; 10(11):776-84. DOI: 10.1097/00003246-198211000-00018
- Cortez GJ. Aspectos bioéticos en el final de la vida: El Derecho a Morir con Dignidad. Cuadernos Hospital de Clínicas. 2006: 51 (2) 97-102.
- Cotogni P. Enteral versus parenteral nutrition in cancer patients: evidences and controversies. Ann Palliat Med. 2016; 5(1):42-9. DOI: 10.3978/j.issn.2224-5820.2016.01.05
- Da Silva JS, Seres DS, Sabino K, et al. Parenteral Nutrition Safety and Clinical Practice Committees, American Society for Parenteral and Enteral Nutrition. ASPEN consensus recommendations for refee-ding syndrome. Nutrition in Clinical Practice, 2020:35(2), 178-195. DOI: 10.1002/ncp.10474
- De Waele E, Malbrain MLNG, Spapen H. Nutrition in Sepsis: A Bench-to-Bedside Review. Nutrients. 2020; 2; 12(2):395. DOI: 10.3390/nu12020395
- Del Río MI, Shand B, Bonati P, et al. Hydration and nutrition at the end of life: a systematic review of emotional impact, perceptions, and decision-making among patients, family, and health care staff. Psychooncology. 2012; 21(9):913-21. DOI: 10.1002/pon.2099
- Driscoll DF. Pharmaceutical and Clinical Aspects of Lipid Injectable Emulsions. JPEN. 2017; 41(1):125-134. DOI: 10.1177/0148607116673187
- Druyan ME, Compher C, Boullata JI, et al; American Society for Parenteral and Enteral Nutrition Board of Directors. Clinical Guidelines For the Use of Parenteral and Enteral Nutrition in Adult and Pe-diatric Patients: applying the GRADE system to development of A.S.P.E.N. clinical guidelines. JPEN. 2012; 36(1):77-80. DOI: 10.1177/0148607111420157
- Felbinger TW, Mayer K, Richter HP. Supplemental parenteral nutrition. Friend or foe? The EPaNIC study. Med Klin Intensivmed Notfmed. 2011; 106(3):218-20. DOI: 10.1007/s00063-011-0055-0
- García de Lorenzo A, Álvarez J, Bermejo T, Gomis P, Piñeiro G. Micronutrientes en nutrición paren-teral. Nutr Hosp. 2009; 24(2): 152-155.
- Gil et al. Tratado de Nutrición Humana. Tomo IV. Buenos Aires; Médica Panamericana; 2 ed; 2010. XXVI, pp.349-55.
- Gillespie L, Raftery AM. Nutrition in palliative and end-of-life care. Br J Community Nurs 2014: Su-ppl: S1520. DOI:10.12968/bjcn.2014.19.Sup7.S15
- Ginguay A, De Bandt JP, Cynober L. Indications and contraindications for infusing specific amino acids (leucine, glutamine, arginine, citrulline, and taurine) in critical illness. Curr Opin Clin Nutr Metab Care. 2016, 19(2):161-9. DOI: 10.1097/MCO.0000000000000255
- Godinjak A, Jusufovic S, Rama A, et al. Hyperlactatemia and the Importance of Repeated Lactate Measurements in Critically Ill Patients. Med Arch. 2017; 71(6):404-407. DOI: 10.5455/me-darh.2017.71.404-407
- Goeters C, Wenn A, Mertes N, et al. L-Alanyl-L-glutamine improves 6-month outcome in critically ill patients improves 6-month outcome in critically ill patients. Crit Care Med. 2002; 30:2032-7. DOI: 10.1097/00003246-200209000-00013
- Grau T, Bonet A, Miñambres E, et al. The effect of L-alanyl-L-glutamine dipeptide supplemented to-tal parenteral nutrition on infectious morbidity and insulin sensitivity in critically ill patients. Crit Care Med. 2011 Jun; 39(6):1263-8. DOI: 10.1097/CCM.0b013e31820eb774
- Grau T, Bonet A, Miñambres E, et al. The effect of L-alanyl-L-glutamine dipeptide supplemented to-tal parenteral nutrition on infectious morbidity and insulin sensitivity in critically ill patients. Crit Care Med. 2011; 39(6):1263-8. DOI: 10.1097/CCM.0b013e31820eb774
- Gudivada KK, Kumar A, Shariff M, et al. Antioxidant micronutrient supplementation in critically ill adults: A systematic review with meta-analysis and trial sequential analysis. Clin Nutr, 2020; 40(3): 740-750. DOI: 10.1016/j.clnu.2020.06.033
- Hardy G, Puzovic M. Formulation, stability, and administration of parenteral nutrition with new li-pid emulsions. Nutr Clin Pract. 2009; 24(5):616-25. DOI: 10.1177/0884533609342445
- Hargreaves IP, Mantle D. Supplementation with selenium and coenzyme Q10 in critically ill pa-tients. Br J Hosp Med (Lond). 2019; 80(10):589-593. DOI: 10.12968/hmed.2019.80.10.589
- Hoffer LJ, Bistrian BR. Nutrition in critical illness: a current conundrum. F1000Res. 2016; 18; 5:2531. DOI: 10.12688/f1000research.9278.1
- Hui D, Dev R, Bruera E. The last days of life: symptom burden and impact on nutrition and hydration in cancer patients. Curr Opin Support Palliat Care. 2015; 9(4): 346-54. DOI: 10.1097/SPC.0000000000000171
- Hutton B, Catalá-López F, Moher D. La extensión de la declaración PRISMA para revisiones sistemáti-cas que incorporan metaanálisis en red: PRISMA-NMA. Med Clin (Barc) 2016; 147(6):231-80.
- Iacone R, Scanzano C, Santarpia L, Cioffi I, Contaldo F, Pasanisi F. Macronutrients in Parenteral Nutrition: Amino Acids. Nutrients. 2020; 12(3):772. DOI: 10.3390/nu12030772
- Jin J, Mulesa L, Carrilero Rouillet M. Trace Elements in Parenteral Nutrition: Considerations for the Prescribing Clinician. Nutrients. 2017 28; 9(5):440. DOI: 10.3390/nu9050440
- Kalil AC, Sevransky JE, Myers DE, Esposito C, Vandivier RW, Eichacker P. Preclinical trial of L-arginine monotherapy alone or with N-acetylcysteine in septic shock. Crit Care Med. 2006; 34(11):2719-28. DOI: 10.1097/01.CCM.0000242757.26245.03
- Koga Y, Povalko N, Inoue E, et al.Therapeutic regimen of L-arginine for MELAS: 9-year, prospective, multicenter, clinical research. J Neurol. 2018; 265(12):2861-2874. DOI: 10.1007/s00415-018-9057-7
- Marian M. Carbohydrate metabolism. A comparison of stress and non stress states, en: Cresci G, editor. Nutrition for the Critically Il Patient. A Guide to Practice. Second edition, Boca Raton, Fl, CRC Press; 2015, pp. 25-70.
- Martí-Bonmatí E, Felíu AP, Tellería AV. Vitamin and oligoelement additives in parenteral nutrition. Farm Hosp. 2011; 35(2):96-7. DOI: 10.1016/j.farma.2010.05.007
- Mayers T, Kashiwagi S, Mathis BJ, et al. International review of national-level guidelines on end-of-life care with focus on the withholding and withdrawing of artificial nutrition and hydration. Geriatr Gerontol Int. 2019; 19(9):847-853. DOI: 10.1111/ggi.13741
- McCarthy MS, Martindale RG. Immunonutrition in Critical Illness: What Is the Role? Nutr Clin Pract. 2018; 33(3):348-358. DOI: 10.1002/ncp.10102
- McCulloch A, Bansiya V, Woodward JM. Addition of Insulin to Parenteral Nutrition for Control of Hyperglycemia. JPEN. 2018; 42(5):846-854. DOI: 10.1177/0148607117722750
- Mechanick JI, Carbone S, Dickerson RN, et al. ASPEN COVID-19 Task Force on Nutrition Research. Clinical Nutrition Research and the COVID-19 Pandemic: A Scoping Review of the ASPEN COVID-19 Task Force on Nutrition Research. JPEN. 2021; 45(1):13-31. DOI: 10.1002/jpen.2036
- Mehta NM, Skillman HE, Irving SY, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Pediatr Crit Care Med. 2017 Jul; 18(7):675-715. DOI: 10.1097/PCC.0000000000001134
- Miloudi K, Comte B, Rouleau T, Montoudis A, Levy E, Lavoie JC. The mode of administration of total parenteral nutrition and nature of lipid content influence the generation of peroxides and aldehydes. Clin Nutr. 2012; 31(4):526-34. DOI: 10.1016/j.clnu.2011.12.012
- Mitchell J, Jatoi A. Parenteral nutrition in patients with advanced cancer: merging perspectives from the patient and healthcare provider. Semin Oncol. 2011; 38(3):439-42. DOI: 10.1053/j.seminon-col.2011.03.020
- Mitrus O, Żuraw M, Losada-Barreiro S, Bravo-Díaz C, Paiva-Martins F. Targeting Antioxidants to Interfaces: Control of the Oxidative Stability of Lipid-Based Emulsions. J Agric Food Chem. 2019; 20; 67(11):3266-3274. DOI: 10.1021/acs.jafc.8b06545
- Novak F, Heyland DK, Avenell A, Drover JW, Su X. Glutamine supplementation in serious illness: a systematic review of the evidence. Crit Care Med. 2002; 30:2022-9. DOI: 10.1097/00003246-200209000-00011
- Palm E, Dotson B. Copper and Zinc Deficiency in a Patient Receiving Long-Term Parenteral Nutrition During a Shortage of Parenteral Trace Element Products. J PEN. 2015; 39(8):986-9. DOI: 10.1177/0148607114549255
- Patel JJ, Codner P. Controversies in Critical Care Nutrition Support. Crit Care Clin. 2016; 32(2):173-89. DOI: 10.1016/j.ccc.2015.11.002
- Reber E, Messerli M, Stanga Z, Mühlebach S. Pharmaceutical Aspects of Artificial Nutrition. J Clin Med. 2019; 19; 8(11):2017. DOI: 10.3390/jcm8112017
- Rivas García F. Alimentación en la enfermedad terminal: Una reflexión desde la biopolítica. Revista Iberoamericana De Bioética.2021; (15): 01-09. https://doi.org/10.14422/rib.i15.y2021.009
- Roberts KM, Nahikian-Nelms M, Ukleja A, Lara LF. Nutritional Aspects of Acute Pancreatitis. Gas-troenterol Clin North Am. 2018; 47(1):77-94. DOI: 10.1016/j.gtc.2017.10.002
- Rosenthal MD, Carrott PW, Patel J, Kiraly L, Martindale RG. Parenteral or Enteral Arginine Supple-mentation Safety and Efficacy. J Nutr. 2016; 146(12):2594S-2600S. DOI: 10.3945/jn.115.228544
- Sadu Singh BK, Narayanan SS, Khor BH, et al. Composition and Functionality of Lipid Emulsions in Parenteral Nutrition: Examining Evidence in Clinical Applications. Front Pharmacol. 2020; 11:506. DOI: 10.3389/fphar.2020.00506
- Salpeter SR, Luo EJ, Malter DS, Stuart B. Systematic review of noncancer presentations with a me-dian survival of 6 months or less. Am J Med. 2012; 125(5):512.e1-6. DOI: 10.1016/j.amjmed.2011.07.028
- SECPAL. Problemas éticos al final de la vida. Disponible en: https://www.secpal.com/PROBLEMAS-ETICOS-AL-FINAL-DE-LA-VIDA consultada el 22/05/2021.
- SENPE. Documento de consenso español sobre preparación de nutrientes parenterales. 2008. ht-tps://senpe.com/documentacion/grupos/ConsensoPreparacion2008.pdf
- Sforzini A, Bersani G, Stancari A, Grossi G, Bonoli A, Ceschel GC. Analysis of all-in-one parenteral nutrition admixtures by liquid chromatography and laser diffraction: study of stability. J Pharm Biomed Anal. 2001; 24(5-6):1099-109. DOI: 10.1016/s0731-7085(00)00564-1
- Singer P, Pichard C. Reconciling divergent results of the latest parenteral nutrition studies in the ICU. Curr Opin Clin Nutr Metab Care. 2013; 16(2):187-93. DOI: 10.1097/MCO.0b013e32835c34be
- Slattery E, Rumore MM, Douglas JS, Seres DS. 3-in-1 vs 2-in-1 parenteral nutrition in adults: a re-view. Nutr Clin Pract. 2014; 29(5):631-5. DOI: 10.1177/0884533614533611
- Smedberg M, Wernerman J. Is the glutamine story over? Crit Care. 2016; 20(1):361. DOI: 10.1186/s13054-016-1531-y
- Stawny M, Olijarczyk R, Jaroszkiewicz E, Jelińska A. Pharmaceutical point of view on parenteral nutrition. Scientific World Journal. 2013; 2013:415310. DOI: 10.1155/2013/415310
- Unger N, Holzgrabe U. Stability and assessment of amino acids in parenteral nutrition solutions. J Pharm Biomed Anal. 2018; 5; 147:125-139. DOI: 10.1016/j.jpba.2017.07.064
- Vega T, Arrieta E, Lozano JE, et al. Atención sanitaria paliativa y de soporte de los equipos de atención primaria en el domicilio. Gac Sanit. 2011; 25(3):205-10. DOI: 10.1016/j.gaceta.2011.02.005
- Vila J. Tecnología Farmacéutica. Vol II: Formas farmacéuticas. Editorial Síntesis. Madrid, 1997, pp. 320-352.
- Walmsley RS. Refeeding syndrome: screening, incidence, and treatment during parenteral nutrition. J Gastroenterol Hepatol. 2013; 28 Suppl 4:113-7. DOI: 10.1111/jgh.12345
- Watrobska-Swietlikowska D, Szlagatys-Sidorkiewicz A, Łuszkiewicz K. Evaluation of physical stabi-lity of all in one parenteral admixtures for pediatric home care with high electrolytes concentrations. Nutr Hosp. 2014; 31(1):236-43. DOI: 10.3305/nh.2015.31.1.7965
- Weijs PJ, Looijaard WG, Beishuizen A, Girbes AR, Oudemans-van Straaten HM. Early high protein intake is associated with low mortality and energy overfeeding with high mortality in non-septic me-chanically ventilated critically ill patients. Crit Care. 2014; 18(6):70. DOI: 10.1186/s13054-014-0701-z
- Windpessl M, Mayrbaeurl B, Baldinger C, et al. Refeeding Syndrome in Oncology: Report of Four Cases. World J Oncol. 2017; 8(1):25-29. DOI: 10.14740/wjon1007w. Epub 2017 Feb 23.
- Wischmeyer PE. Glutamine: mode of action in critical illness. Crit Care Med. 2007; 35(9 Suppl): S541-4. DOI: 10.1097/01.CCM.0000278064.32780.D3