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Sommacal HM, Gazal CH, Jochims AM, Beghetto M, Paz A, Silla LM, Mello ED
Rev Bras Hematol Hemoter. 2012;34(5):334-8
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The duration of PN may have an impact on catheter-related
infection rates and on hospitalization costs. In the literature, the
mean duration of PN after HSCT ranges from 6.9-16 days after
autologous transplantation and 10.3-25 days after allogeneic
transplantation
(15,16,23)
. The present study showed a reduction in PN
duration in the IG. Use of a nutritional care protocol, including
control and optimization of food intake, in these patients may
reduce the duration of PN by approximately 14 days in patients
undergoing related-donor allogeneic HSCT. We found in this work
a median duration of PN of 6.5 days (range: 1-28) in related-donor
graft recipients and 11 days (range: 1-21) in unrelated-donor graft
recipients. This duration is well short of that usually reported in the
literature for allogeneic HSCT recipients. Although other factors
associated with better care in these patients (such as better use of
antiemetics and prophylaxis for GVHD) may have had an impact,
monitoring of dietary intake plays an essential role in determining
when to discontinue parenteral nutrition
(16)
.
We believe PN should not be used routinely as first-line
therapy, but rather restricted to patients who are unable to tolerate
enteral feeding and will derive real benefit from PN
(24)
.
HSCT patients who receive PN, when indicated, may
experience fewer complications when adequate nutritional support
is provided
(13,25)
. Furthermore, the lack of adequate nutritional
support may lead to increased complication rates and prolong
hospitalization, consequently leading to higher hospital costs
(14,23)
.
Conclusion
The implementation of a systematic nutritional follow-up
and therapy protocol for adult patients undergoing allogeneic
hematopoietic stem cell transplantation optimized (shortened) the
duration of parenteral nutrition.
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