PMID- 26187939
OWN - NLM
STAT- MEDLINE
DCOM- 20171228
LR  - 20180309
IS  - 1941-2444 (Electronic)
IS  - 0148-6071 (Linking)
VI  - 41
IP  - 3
DP  - 2017 Mar
TI  - Expediting Transition to Home Parenteral Nutrition With Fast-Track Cycling.
PG  - 446-454
LID - 10.1177/0148607115595620 [doi]
AB  - BACKGROUND: Delivery of home parenteral nutrition (PN) is typically cycled over 
      12 hours. Discharge to home on PN is often delayed due to potential adverse 
      events (AEs) associated with cycling PN. The purpose was to determine whether 
      patients requiring long-term PN can be cycled from 24 hours to 12 hours in 1 day 
      instead of 2 days without increasing the risk of PN-related AEs. METHODS: 
      Hospitalized patients receiving PN at goal calories infused over 24 hours without 
      severe electrolyte or blood glucose abnormalities were eligible. Patients were 
      randomly assigned to a 1-step "fast-track" protocol or 2-step "standard" 
      protocol. AEs were defined as hypoglycemia or hyperglycemia, new-onset or 
      worsening dyspnea, tachycardia, tachypnea, lower extremity or sacral edema, 
      pulmonary edema, or abdominal ascites and were graded as minor or major. RESULTS: 
      In the 63 patients studied, the most prevalent PN-related AE was hyperglycemia, 
      occurring in 24.2% and 30.0% of patients in the fast-track and standard groups, 
      respectively. Overall, there was no significant difference in the prevalence of 
      PN-related minor AEs between fast-track and standard groups (33.3% and 53.3%, P = 
      .5). No major PN-related AEs occurred in the fast-track group, while 1 major 
      PN-related AE (pulmonary edema) occurred in the standard group. CONCLUSIONS: 
      Fast-track cycling is as safe as standard cycling in patients without diabetes 
      mellitus or major organ dysfunction requiring long-term PN. Fast-track cycling 
      could potentially expedite hospital discharge, resulting in decreased healthcare 
      costs and improved patient satisfaction.
FAU - Austhof, Sandra I
AU  - Austhof SI
AD  - 1 Center for Human Nutrition TT-22, Cleveland Clinic, Cleveland, Ohio, USA.
FAU - DeChicco, Robert
AU  - DeChicco R
AD  - 1 Center for Human Nutrition TT-22, Cleveland Clinic, Cleveland, Ohio, USA.
FAU - Cresci, Gail
AU  - Cresci G
AD  - 2 Gastroenterology and Hepatology M-17, Cleveland Clinic, Cleveland, Ohio, USA.
FAU - Corrigan, Mandy L
AU  - Corrigan ML
AD  - 3 Nutrition Support Consultant, Chesterfield, Missouri, USA.
FAU - Lopez, Rocio
AU  - Lopez R
AD  - 4 Quantitative Health Sciences JJN3-01, Cleveland Clinic, Cleveland, Ohio, USA.
FAU - Steiger, Ezra
AU  - Steiger E
AD  - 5 Center for Human Nutrition/General Surgery A100, Cleveland Clinic, Cleveland, 
      Ohio, USA.
FAU - Kirby, Donald F
AU  - Kirby DF
AD  - 6 Center for Human Nutrition/Gastroenterology A51, Cleveland Clinic, Cleveland, 
      Ohio, USA.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20160929
PL  - United States
TA  - JPEN J Parenter Enteral Nutr
JT  - JPEN. Journal of parenteral and enteral nutrition
JID - 7804134
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Glucose/metabolism
MH  - Female
MH  - Hospitalization
MH  - Humans
MH  - Hyperglycemia/*blood/etiology
MH  - Hypoglycemia/*blood/etiology
MH  - Male
MH  - Middle Aged
MH  - Parenteral Nutrition, Home/*methods
MH  - Patient Discharge
MH  - Sample Size
OTO - NOTNLM
OT  - adult
OT  - cycling parenteral nutrition
OT  - home nutrition support
OT  - life cycle
OT  - nutrition
OT  - parenteral nutrition
EDAT- 2015/07/19 06:00
MHDA- 2017/12/29 06:00
CRDT- 2015/07/19 06:00
PHST- 2015/07/19 06:00 [pubmed]
PHST- 2017/12/29 06:00 [medline]
PHST- 2015/07/19 06:00 [entrez]
AID - 0148607115595620 [pii]
AID - 10.1177/0148607115595620 [doi]
PST - ppublish
SO  - JPEN J Parenter Enteral Nutr. 2017 Mar;41(3):446-454. doi: 
      10.1177/0148607115595620. Epub 2016 Sep 29.