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MON-PP018: Clinical Benefits of Pump Infusion Pressure Monitoring in Patients on Home Parenteral Nutrition
S134
Poster presentations
Table: Pearson correlation coefficients with fat mass by Air Displacement Plethysmography Variable Body mass index (kg/m2 ) Abdominal circumference (cm) Hip circumference (cm) Fat mass Body Adiposity Index
Estimated
0.558 0.265 0.559 0.676
95% CI
p value
Inferior
Superior
0.294 0.055 0.296 0.459
0.743 0.536 0.743 0.817
<0.001 0.103 <0.001 <0.001
Conclusion: BAI does not adequately estimate FM in Brazilian obese subjects. Therefore, BAI use in other than MexicanAmerican and African-American populations must be used with caution. References Bergman RN, Stefanovski D, Buchanan TA, et al. A better index of body adiposity. Obesity (Silver Spring). 2011; 19(5): 1083 1089. Disclosure of Interest: The authors have no conflicts of interest to declare. This study was approved by Ethical Committee of University of S˜ ao Paulo and Metanutri-Lim 35 support. Research supported by FAPESP 2011/09612 3 e Research Grant 2012/15677 3.
MON-PP018 Outstanding abstract CLINICAL BENEFITS OF PUMP INFUSION PRESSURE MONITORING IN PATIENTS ON HOME PARENTERAL NUTRITION M. Small1 , K. Moira2 , J.C. Cascailh3 , A. Tsoukalis4 , S. Gabe1 . 1 Clinical Nutrition, St Mark’s Hospital, Harrow, 2 Inspiration Healthcare, Earl Shilton, United Kingdom; 3 Micrel Medical Devices, Nice, France; 4 Micrel Medical Devices, Athens, Greece Rationale: Previous industry liaison resulted in a system to monitor infusion pressures [1]. This follow-on study aimed to identify the normal pressures in patients on home parenteral nutrition (HPN) and if these could aid in the diagnosis and treatment of catheter problems. Methods: 27 patients consented to be monitored. Pressures were recorded on the Micrel PN+ pump and exported to a secure server. Any HPN patient with a partial or total catheter occlusion had infusion pressures measured pre and post patency intervention. Results: 5910 infusions were recorded from 27 patients. Average infusion pressure was 0.29±0.1 bar (0.01 0.85) and did not increase with infusion rate (r = 0.3). 21 (78%) patients had open ended devices, 4 (15%) valved and 2 (7%) implanted ports. There was no difference between devices p = 0.91. There were 62 (1%) readings above the Upper Confidence Interval of 0.58 bar from 7 patients. 50 (81%) were from 1 patient with a valved port who reported multiple downstream occlusions. The alarms stopped after changing to a longer Huber™ needle, but high readings were still recorded. Comparison with readings from a non valved port revealed those from the valved port were significantly higher p < 0.0001. 1 patient with clinically confirmed thrombosis had a pressure spike of 0.67 bar 5 days before presenting with symptoms. Pressures in the preceding 6 months were within normal limits (0.58 bar). 6 patients (not on the Micrel PN+) had a partial or total occlusion. Mean preintervention pressure was 0.31±0.048 bar, post-intervention it was 0.2±0.055 bar, p = 0.007. Conclusion: This study describes the normal range of infusion pressures in patients on HPN and how these might be used
in the diagnosis and treatment of catheter problems such as occlusion or thrombosis. Sudden spikes in infusion pressure may be indicative of an upcoming complication, however further study is needed. References [1] Gabe et al. (2013) Clin Nutr 32 (Suppl 1) S15. Disclosure of Interest: M. Small: None declared, K. Moira Paid Instructor at: Micrel Medical devices, J. Cascailh Other: Employee Micrel Medical Devices, A. Tsoukalis Other: Employee Micrel Medical Devices, S. Gabe: None declared
Poster tour 9: Techniques and formulations 3 MON-PP019 Outstanding abstract SENSORY ATTRIBUTES AND PREFERENCE OF LOW-VOLUME ORAL NUTRITIONAL SUPPLEMENTS (ONS) C. Fry1 , A. Cawood1 , A. Ashouri2 . 1 Medical Affairs, Nutricia, Trowbridge, 2 Leatherhead Food Research, Leatherhead, Surrey, United Kingdom Rationale: Studies have highlighted the importance of energydense low-volume ONS for achieving good compliance (Hubbard et al. 2012). It is well known that sensory attributes also influence compliance; therefore this study aimed to compare sensory perceptions of different 2.4 kcal/ml low-volume ONS. Methods: In a single blind cross-over study 100 participants (57% female, mean age 67±6 y) compared three energy-dense low-volume ONS (300 kcal, 12 13 g protein, 125 ml; Products A and B, reformulated and old Fortisip Compact, respectively and Product C, Ensure® Compact) in a variety of flavours. Each product was scored for overall liking, appearance, aroma, flavour, texture and aftertaste based on a 9-point hedonic scale (1 “dislike extremely” to 9 “like extremely”). Participants were also asked to choose their overall product preference. Results: Data showed that Product A rated significantly higher than Products B and C for appearance, flavour and texture (Table 1) and higher for all other attributes apart from aroma for which Products A and C scored equal. Product A was preferred overall compared with Products B and C (41% vs. 25% and 34%, respectively). Table 1: Sensory attribute scores (mean±SD) Product
Appearance
Flavour
Texture
A B C
6.5±1.2 6.2±1.3* 6.2±1.4*
5.9±1.7 5.6±1.8* 5.6±1.9*
6.3±1.3 6.0±1.4* 6.0±1.6*
*Significantly different to Product A (P < 0.05), signed Wilcoxon-rank test.
Conclusion: Results show variations in the perception of sensory attributes of different energy-dense, low-volume ONS which appear to influence overall preference. Sensory preferences should be considered when developing ONS as this may improve compliance which is important to achieve optimal clinical outcomes. References Hubbard GP et al. Clin Nutr. 2012; 31: 293 312. Disclosure of Interest: C. Fry Other: Employee of Nutricia, A. Cawood Other: Employee of Nutricia, A. Ashouri Grant/Research Support from: Supported by funding from Nutricia
Poster presentations
Table: Pearson correlation coefficients with fat mass by Air Displacement Plethysmography Variable Body mass index (kg/m2 ) Abdominal circumference (cm) Hip circumference (cm) Fat mass Body Adiposity Index
Estimated
0.558 0.265 0.559 0.676
95% CI
p value
Inferior
Superior
0.294 0.055 0.296 0.459
0.743 0.536 0.743 0.817
<0.001 0.103 <0.001 <0.001
Conclusion: BAI does not adequately estimate FM in Brazilian obese subjects. Therefore, BAI use in other than MexicanAmerican and African-American populations must be used with caution. References Bergman RN, Stefanovski D, Buchanan TA, et al. A better index of body adiposity. Obesity (Silver Spring). 2011; 19(5): 1083 1089. Disclosure of Interest: The authors have no conflicts of interest to declare. This study was approved by Ethical Committee of University of S˜ ao Paulo and Metanutri-Lim 35 support. Research supported by FAPESP 2011/09612 3 e Research Grant 2012/15677 3.
MON-PP018 Outstanding abstract CLINICAL BENEFITS OF PUMP INFUSION PRESSURE MONITORING IN PATIENTS ON HOME PARENTERAL NUTRITION M. Small1 , K. Moira2 , J.C. Cascailh3 , A. Tsoukalis4 , S. Gabe1 . 1 Clinical Nutrition, St Mark’s Hospital, Harrow, 2 Inspiration Healthcare, Earl Shilton, United Kingdom; 3 Micrel Medical Devices, Nice, France; 4 Micrel Medical Devices, Athens, Greece Rationale: Previous industry liaison resulted in a system to monitor infusion pressures [1]. This follow-on study aimed to identify the normal pressures in patients on home parenteral nutrition (HPN) and if these could aid in the diagnosis and treatment of catheter problems. Methods: 27 patients consented to be monitored. Pressures were recorded on the Micrel PN+ pump and exported to a secure server. Any HPN patient with a partial or total catheter occlusion had infusion pressures measured pre and post patency intervention. Results: 5910 infusions were recorded from 27 patients. Average infusion pressure was 0.29±0.1 bar (0.01 0.85) and did not increase with infusion rate (r = 0.3). 21 (78%) patients had open ended devices, 4 (15%) valved and 2 (7%) implanted ports. There was no difference between devices p = 0.91. There were 62 (1%) readings above the Upper Confidence Interval of 0.58 bar from 7 patients. 50 (81%) were from 1 patient with a valved port who reported multiple downstream occlusions. The alarms stopped after changing to a longer Huber™ needle, but high readings were still recorded. Comparison with readings from a non valved port revealed those from the valved port were significantly higher p < 0.0001. 1 patient with clinically confirmed thrombosis had a pressure spike of 0.67 bar 5 days before presenting with symptoms. Pressures in the preceding 6 months were within normal limits (0.58 bar). 6 patients (not on the Micrel PN+) had a partial or total occlusion. Mean preintervention pressure was 0.31±0.048 bar, post-intervention it was 0.2±0.055 bar, p = 0.007. Conclusion: This study describes the normal range of infusion pressures in patients on HPN and how these might be used
in the diagnosis and treatment of catheter problems such as occlusion or thrombosis. Sudden spikes in infusion pressure may be indicative of an upcoming complication, however further study is needed. References [1] Gabe et al. (2013) Clin Nutr 32 (Suppl 1) S15. Disclosure of Interest: M. Small: None declared, K. Moira Paid Instructor at: Micrel Medical devices, J. Cascailh Other: Employee Micrel Medical Devices, A. Tsoukalis Other: Employee Micrel Medical Devices, S. Gabe: None declared
Poster tour 9: Techniques and formulations 3 MON-PP019 Outstanding abstract SENSORY ATTRIBUTES AND PREFERENCE OF LOW-VOLUME ORAL NUTRITIONAL SUPPLEMENTS (ONS) C. Fry1 , A. Cawood1 , A. Ashouri2 . 1 Medical Affairs, Nutricia, Trowbridge, 2 Leatherhead Food Research, Leatherhead, Surrey, United Kingdom Rationale: Studies have highlighted the importance of energydense low-volume ONS for achieving good compliance (Hubbard et al. 2012). It is well known that sensory attributes also influence compliance; therefore this study aimed to compare sensory perceptions of different 2.4 kcal/ml low-volume ONS. Methods: In a single blind cross-over study 100 participants (57% female, mean age 67±6 y) compared three energy-dense low-volume ONS (300 kcal, 12 13 g protein, 125 ml; Products A and B, reformulated and old Fortisip Compact, respectively and Product C, Ensure® Compact) in a variety of flavours. Each product was scored for overall liking, appearance, aroma, flavour, texture and aftertaste based on a 9-point hedonic scale (1 “dislike extremely” to 9 “like extremely”). Participants were also asked to choose their overall product preference. Results: Data showed that Product A rated significantly higher than Products B and C for appearance, flavour and texture (Table 1) and higher for all other attributes apart from aroma for which Products A and C scored equal. Product A was preferred overall compared with Products B and C (41% vs. 25% and 34%, respectively). Table 1: Sensory attribute scores (mean±SD) Product
Appearance
Flavour
Texture
A B C
6.5±1.2 6.2±1.3* 6.2±1.4*
5.9±1.7 5.6±1.8* 5.6±1.9*
6.3±1.3 6.0±1.4* 6.0±1.6*
*Significantly different to Product A (P < 0.05), signed Wilcoxon-rank test.
Conclusion: Results show variations in the perception of sensory attributes of different energy-dense, low-volume ONS which appear to influence overall preference. Sensory preferences should be considered when developing ONS as this may improve compliance which is important to achieve optimal clinical outcomes. References Hubbard GP et al. Clin Nutr. 2012; 31: 293 312. Disclosure of Interest: C. Fry Other: Employee of Nutricia, A. Cawood Other: Employee of Nutricia, A. Ashouri Grant/Research Support from: Supported by funding from Nutricia