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LB006-SUN HOME PARENTERAL NUTRITION (HPN): AN INTERNATIONAL BENCHMARKING EXERCISE
Late Breaking Abstracts I
207
shows a good level of agreement with the screening tool considered as the ‘gold standard’, and also has a high reliability.
LB007-SUN REFEEDING HYPOPHOSPHATAEMIA INCIDENCE IN A MEDICAL INTENSIVE CARE UNIT
Disclosure of Interest: None Declared
R. Coskun1 , K. Gundogan1 , S. Baldane2 , M. Guven1 , M. Sungur1 . 1 Internal Medicine Intensive Care Unit, 2 Internal Medicine, Erciyes University, Kayseri, Turkey
LB006-SUN HOME PARENTERAL NUTRITION (HPN): AN INTERNATIONAL BENCHMARKING EXERCISE J. Baxter1 , L. Gillanders2 , K. Angstmann3 , M. Staun4 , C. O’Hanlon5 , T. Smith6 , F. Joly7 , P. Thul8 , C. Jonkers9 , K. Gardiner10 , S. Klek11 , C. Cuerda12 , W. Magambo13 , A. van Gossum14 , L. Pironi15 . 1 HPN network, Dundee, United Kingdom; 2 Nutrition Services, Auckland City Hospital, Auckland, New Zealand; 3 Sydney, New South Wales, Australia; 4 Rigshospitalet, Copenhagen, Denmark; 5 Beaumont Hospital, Dublin, Ireland; 6 Southampton General Hospital, Southampton, United Kingdom; 7 Hopital Beaujon, Paris, France; 8 Charite Hospital, Berlin, Germany; 9 Academic Medical Centre, Amsterdam, Netherlands; 10 Belfast City Hospital, Belfast, United Kingdom; 11 University Medical College, Krakow, Poland; 12 Hospital General Universitario, Madrid, Spain; 13 University Hospital of Wales, Cardiff, United Kingdom; 14 Erasme Hospital, Brussels, Belgium; 15 University of Bologna, Bologna, Italy Rationale: The aim was to compare the organisation of HPN internationally. Methods: Colleagues completed a questionnaire for their country and collated. The population and number of HPN patients treated were used to calculate point (31st December 2010) and 2010 period prevalence/million; number of centres (managing >5 patients). The existence of organised care guidelines/standards; referral pathways, education programmes. Results: 15 countries treat approximately 8930 patients 12 (80%) had or had adopted guidelines; 11 (73%) had an education programme*. Country
Population (M)
Prev
Pt. prev
No. of centres
Referral path?
Organisation?
Australia* Belgium Denmark Eire England* France* Germany* Italy* Netherlands* N.Ireland* NZ Poland* Scotland* Spain* Wales*
22.2 10.5 5.3 4.2 51.8 63.1 82 60 17 1.7 4.2 38.2 5.3 46.2 2.9
6.7 11 66 6.4 10 6 unknown 33.3 14.7 18.8 7.2 25 23 3.25 unknown
5.1 8 47 3.8 8.3 unknown 49 unknown unknown 14.1 5.3 22.3 17.5 2.7 unknown
9 7 3 0 21 >14 few 90 2 1 1 26 11 7 3
no no yes no no no no no yes no no yes yes no yes
no no no no no no no no yes yes no yes yes no yes
Conclusion: There is a wide range in HPN prevalence figures and the existence of organised care varies across the countries studied. Most countries either had developed their own clinical guidelines or standards or had adopted an international society guideline to improve patient care. It is recognised that several countries have under reported the HPN prevalence as registries are not fully available or used. This comparative data is interesting to enable the planning of equitable care. Disclosure of Interest: None Declared
Rationale: The aim of the study was to determine the overall and comparative incidence of Refeeding hypophosphataemia (RH) between enteral and parenteral feeding in general adult intensive care patients. Methods: Study performed as a retrospective analysis. One hundred patients received enteral or parenteral nutrition included into the study. Hypophosphatemia was existed in 15 patients before ignition of nutrition and they were excluded from the analysis. Demographic characteristics, type of nutrition, daily caloric intake, serum phosphorus levels before and after initiation of nutrition were recorded for seven days. Results: Parenteral nutrition (PN) was given to 27.1% of the patients, enteral nutrition (EN) was the preferred route in 51.8% and 21.2% of the patients received PN+EN. RH was observed in 41 (48.2%) patients. Distribution of RH frequencies according to days after initiation of the nutritional support was as follows; 11 (26.8%) on the 1st day, 13 (31.7%) on the 2nd day, 9 (22.0%) on the 3rd day, 2 (4.9%) on the 4th day, 3 (7.3%) on the 6th day and 3 (7.3%) on the 7th day. RH rates in patients receiving PN, EN and PN+EN were 43%, 52% and 44% respectively. There was a weak negative correlation between phosphorus and calories given on the first, second and third days (1st day r = 0.006, p = 0.973, 2nd day r = 0.180 p = 0.261, 3rd day r = 0.174 p = 0.297). Conclusion: There are significant risk factors for development of reefeding syndrome in medical critically ill patients because of high incidence of malnutrion on admission critical care unit. We determined high incidence of refeeding hypophospatemia in both patients receiving parenteral and entereal nutrition. Although we couldn’t show any correlation between amount of calories given and rate of hypophosphatemia, calories should be increased gradually and phosphorus levels should be followed closely in medical intensive care unit patients. Disclosure of Interest: None Declared
LB008-SUN TREATMENT OF IRON DEFICIENCY ANEMIA IN CHRONIC DISEASE. RESULTS FROM 3 GERMAN NON-INTERVENTIONAL STUDIES J. Stein1,2 , A. Dignass1,3 , R.M. Schaefer4 , N. Marschner5 , R. Rohrberg6 , H. Tesch7 , S. Weber-Mangal8 , T. Steinmetz9 . 1 Crohn & Colitis Center, 2 Medical Clinic, St. Elisabeth Hospital, 3 Agaplesion Mrkus Hospital, Frankfurt, 4 Medical Policlinic, University Hospital, M¨ unster, 5 Practice for Oncology and Hematology, Freiburg, 6 Oncology Outpatient Clinic, Halle/Saale, 7 Outpatient Clinic, Frankfurt, 8 Vifor Pharma, Munich, 9 Outpatient Clinic, Cologne, Germany Rationale: Non-dialysis dependent chronic kidney disease (ND-CKD), inflammatory bowel disease (IBD) and oncological malignancies differ in terms of pathogenesis and
207
shows a good level of agreement with the screening tool considered as the ‘gold standard’, and also has a high reliability.
LB007-SUN REFEEDING HYPOPHOSPHATAEMIA INCIDENCE IN A MEDICAL INTENSIVE CARE UNIT
Disclosure of Interest: None Declared
R. Coskun1 , K. Gundogan1 , S. Baldane2 , M. Guven1 , M. Sungur1 . 1 Internal Medicine Intensive Care Unit, 2 Internal Medicine, Erciyes University, Kayseri, Turkey
LB006-SUN HOME PARENTERAL NUTRITION (HPN): AN INTERNATIONAL BENCHMARKING EXERCISE J. Baxter1 , L. Gillanders2 , K. Angstmann3 , M. Staun4 , C. O’Hanlon5 , T. Smith6 , F. Joly7 , P. Thul8 , C. Jonkers9 , K. Gardiner10 , S. Klek11 , C. Cuerda12 , W. Magambo13 , A. van Gossum14 , L. Pironi15 . 1 HPN network, Dundee, United Kingdom; 2 Nutrition Services, Auckland City Hospital, Auckland, New Zealand; 3 Sydney, New South Wales, Australia; 4 Rigshospitalet, Copenhagen, Denmark; 5 Beaumont Hospital, Dublin, Ireland; 6 Southampton General Hospital, Southampton, United Kingdom; 7 Hopital Beaujon, Paris, France; 8 Charite Hospital, Berlin, Germany; 9 Academic Medical Centre, Amsterdam, Netherlands; 10 Belfast City Hospital, Belfast, United Kingdom; 11 University Medical College, Krakow, Poland; 12 Hospital General Universitario, Madrid, Spain; 13 University Hospital of Wales, Cardiff, United Kingdom; 14 Erasme Hospital, Brussels, Belgium; 15 University of Bologna, Bologna, Italy Rationale: The aim was to compare the organisation of HPN internationally. Methods: Colleagues completed a questionnaire for their country and collated. The population and number of HPN patients treated were used to calculate point (31st December 2010) and 2010 period prevalence/million; number of centres (managing >5 patients). The existence of organised care guidelines/standards; referral pathways, education programmes. Results: 15 countries treat approximately 8930 patients 12 (80%) had or had adopted guidelines; 11 (73%) had an education programme*. Country
Population (M)
Prev
Pt. prev
No. of centres
Referral path?
Organisation?
Australia* Belgium Denmark Eire England* France* Germany* Italy* Netherlands* N.Ireland* NZ Poland* Scotland* Spain* Wales*
22.2 10.5 5.3 4.2 51.8 63.1 82 60 17 1.7 4.2 38.2 5.3 46.2 2.9
6.7 11 66 6.4 10 6 unknown 33.3 14.7 18.8 7.2 25 23 3.25 unknown
5.1 8 47 3.8 8.3 unknown 49 unknown unknown 14.1 5.3 22.3 17.5 2.7 unknown
9 7 3 0 21 >14 few 90 2 1 1 26 11 7 3
no no yes no no no no no yes no no yes yes no yes
no no no no no no no no yes yes no yes yes no yes
Conclusion: There is a wide range in HPN prevalence figures and the existence of organised care varies across the countries studied. Most countries either had developed their own clinical guidelines or standards or had adopted an international society guideline to improve patient care. It is recognised that several countries have under reported the HPN prevalence as registries are not fully available or used. This comparative data is interesting to enable the planning of equitable care. Disclosure of Interest: None Declared
Rationale: The aim of the study was to determine the overall and comparative incidence of Refeeding hypophosphataemia (RH) between enteral and parenteral feeding in general adult intensive care patients. Methods: Study performed as a retrospective analysis. One hundred patients received enteral or parenteral nutrition included into the study. Hypophosphatemia was existed in 15 patients before ignition of nutrition and they were excluded from the analysis. Demographic characteristics, type of nutrition, daily caloric intake, serum phosphorus levels before and after initiation of nutrition were recorded for seven days. Results: Parenteral nutrition (PN) was given to 27.1% of the patients, enteral nutrition (EN) was the preferred route in 51.8% and 21.2% of the patients received PN+EN. RH was observed in 41 (48.2%) patients. Distribution of RH frequencies according to days after initiation of the nutritional support was as follows; 11 (26.8%) on the 1st day, 13 (31.7%) on the 2nd day, 9 (22.0%) on the 3rd day, 2 (4.9%) on the 4th day, 3 (7.3%) on the 6th day and 3 (7.3%) on the 7th day. RH rates in patients receiving PN, EN and PN+EN were 43%, 52% and 44% respectively. There was a weak negative correlation between phosphorus and calories given on the first, second and third days (1st day r = 0.006, p = 0.973, 2nd day r = 0.180 p = 0.261, 3rd day r = 0.174 p = 0.297). Conclusion: There are significant risk factors for development of reefeding syndrome in medical critically ill patients because of high incidence of malnutrion on admission critical care unit. We determined high incidence of refeeding hypophospatemia in both patients receiving parenteral and entereal nutrition. Although we couldn’t show any correlation between amount of calories given and rate of hypophosphatemia, calories should be increased gradually and phosphorus levels should be followed closely in medical intensive care unit patients. Disclosure of Interest: None Declared
LB008-SUN TREATMENT OF IRON DEFICIENCY ANEMIA IN CHRONIC DISEASE. RESULTS FROM 3 GERMAN NON-INTERVENTIONAL STUDIES J. Stein1,2 , A. Dignass1,3 , R.M. Schaefer4 , N. Marschner5 , R. Rohrberg6 , H. Tesch7 , S. Weber-Mangal8 , T. Steinmetz9 . 1 Crohn & Colitis Center, 2 Medical Clinic, St. Elisabeth Hospital, 3 Agaplesion Mrkus Hospital, Frankfurt, 4 Medical Policlinic, University Hospital, M¨ unster, 5 Practice for Oncology and Hematology, Freiburg, 6 Oncology Outpatient Clinic, Halle/Saale, 7 Outpatient Clinic, Frankfurt, 8 Vifor Pharma, Munich, 9 Outpatient Clinic, Cologne, Germany Rationale: Non-dialysis dependent chronic kidney disease (ND-CKD), inflammatory bowel disease (IBD) and oncological malignancies differ in terms of pathogenesis and