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HIGH PROTEIN TYPE AND COMMON TYPE
S98
Poster presentations
Trends in lifestyle factors were wearing multiple rings, 13(62%) patients, with 7 (54%) not removing them during procedures, and ongoing dental problems 7 (33%) patients. There was no correlation between lifestyle factors and number of CRBSI, r = 0.01, P = 0.4. In the year prior to reassessment the number of CRBSI per patient was 1 3, mean 1.6, mode 1. In the following year 0 2, mean 0.5, mode 0. This was not statistically significant P = 0.1. Conclusion: While the reduction in CRBSI following tailored advice was not statistically significant, detailed reassessment identified many areas of non adherence suggesting periodic re-evaluation is of use.
Nutricia, Baxter, Pfizer, MSD, Other: Nutricia, K. Majewska: None Declared, D. Kociszewska: None Declared, J. Pałuba: None Declared, I. Foltyn: None Declared, R. Hertz: None Declared, M. Kowalewska: None Declared, M. Omidi: None Declared, J. Kaczanowska: None Declared
Disclosure of Interest: None Declared
Rationale: The common type formula is not able to provide enough energy and protein for the patients in the postoperative first few days. In contrast, when the patients receive the high energy/high protein formula, most patients show high BUN in several days after surgery. To avoid these problems, a new schedule of postoperative early enteral nutrition using two type enteral formulas was tried. Methods: 18 gastric cancer patients who undertook the gastric surgery were enrolled for this trial. 6 patients (trial group) received the high-energy/high-protein formula (1.5 kcal/ml, protein 9.5 g/100 ml) on 1 3 POD, and the common type formula(1.0 kcal/ml, protein 4 g/100 ml) after 4 6POD. 6 patients (high group) received the high energy/high protein formula, and 6 patients (common group) received the common type formula. The velocity of postoperative early enteral nutrition through the jejunostomy is 10 ml/h on 1POD, 20 ml/h on 2POD, 40 ml/h on 3POD, 60 ml/h on 4POD-6POD. Results: The background of the three groups showed no significant difference. N-balance of trial and high group showed positivity on 2POD, however that of common group on 4POD. N-balance of high group was statistically superior to other two groups after 4POD up to 6POD (P < 0.05). BS, ALB, TT levels showed no statistical difference among 3 groups, but high group revealed higher BUN level than trial group on 6POD (P < 0.05). All cases of high group showed high BUN levels more than 20 mg/dl on 6POD. Conclusion: This new schedule of postoperative early enteral nutrition using high energy/high protein formula in postoperative first 3 days and the common type after 4POD showed early positivity of N-balance and stable BUN.
PP199-SUN SYSTEM OR BUNDLES WHERE IS THE KEY FOR PREVENTION CATHETER RELATED BLOOD STREAM INFECTIONS IN HOSPITAL PARENTERAL NUTRITION? M. Pertkiewicz1 , K. Majewska1 , D. Kociszewska2 , J. Pałuba2 , I. Foltyn3 , R. Hertz3 , M. Kowalewska1 , M. Omidi3 , J. Kaczanowska1 . 1 General Surgery and Clinical Nutrition, Medical University of Warsaw, 2 Clinical Bacteriology, 3 General Surgery and Clinical Nutrition, W. Orlowski University Hospital, Warsaw, Poland Rationale: Implementation of catheter care bundles into catheter care has decreased catheter related blood stream infections (CRBSI) rate in ICU, but less or not in other wards with related CRBSI rate between 2 30/1000 PN days [1,2]. It was suggested that higher CRBSI rate is connected with use of compounding bags [2]. Aim was evaluation of CRBSI rate in IFU, where bags are compounded aseptically but not under strict aseptic conditions but several prophylactic measures are obligatory. Methods: Patients records from the last ten years (2003 2012) were reviewed and compared with results of blood cultures collected by Dept. of Clinical Bacteriology. CRBSI rate in two periods, different in approach to line care was compared. In 2003 Jan. 2007 the both peripheral and central lines were cared by all ward nurses after training and from Feb. 2007 new rules were applied, including four levels of approval to care venous access: 0 The strict ban to handle venous access by improperly trained personnel; I peripheral lines only all nurses after training; II central line connection/disconnection PN nurses; III central line therapeutic measures (antibiotic/ethanol lock, blood sampling, reopening blocked catheters etc. after additional training; IV teacher status: gained ability to train staff and patients. Results: The CRBSI rate in the first period was 1.63/ 1000 PN days with rise in January 2007 to 12/1000 PN days, when outside contract nurses were employed and 0.17/ 1000 PN days from Feb. 2007 till Jan. 2013 (OR 0.1, p < 0.001). From 8 CRBSI observed in this time, 4 were related to broken rules of patient preparation for catheter insertion. Conclusion: Line care is critical for avoiding CRBSI and presented system allows for significant decrease CRBSI rate. References [1] Ishikava Y et al., Ann Surg 2010, 251, 620. [2] Pontes-Arruda A et al, Clinical Nutrition 31 (2012), 728 734. Disclosure of Interest: M. Pertkiewicz Grant/Research Support: Nutricia, Consultant for: NPS/Nycomed, Speakers bureau of: BBraun,
PP200-SUN POSTOPERATIVE EARLY ENTERAL NUTRITION USING TWO TYPE ENTERAL FORMULA, HIGH ENERGY/HIGH PROTEIN TYPE AND COMMON TYPE M.J. Maruyama1 . 1 Surgery, Tokyo Metropolitan Ohkubo Hospital, Tokyo, Japan
Disclosure of Interest: None Declared
PP201-SUN LONG-TERM TAUROLIDINE LOCK THERAPY IS MORE EFFECTIVE IN PREVENTING CATHETER RELATED BLOODSTREAM INFECTIONS IN ADULT HOME PARENTERAL NUTRITION PATIENTS THAN HEPARIN: A FOLLOW-UP OF 212 PATIENTS E.D. Olthof1 , G.J. Huisman1 , M.W. Versleijen1 , W. Kievit2 , G.J. Wanten1 . 1 Department of Gastroenterology and Hepatology, 2 Department of Health Evidence, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands Rationale: Home parenteral nutrition (HPN) patients are at risk for developing catheter-related bloodstream infections (CRBSI). In a previous prospective open-label randomized controlled trial in 30 HPN patients presenting with CRBSI we showed that catheter locking with 2% taurolidine dramatically (90%) reduced re-infections compared with low-dose (150
Poster presentations
Trends in lifestyle factors were wearing multiple rings, 13(62%) patients, with 7 (54%) not removing them during procedures, and ongoing dental problems 7 (33%) patients. There was no correlation between lifestyle factors and number of CRBSI, r = 0.01, P = 0.4. In the year prior to reassessment the number of CRBSI per patient was 1 3, mean 1.6, mode 1. In the following year 0 2, mean 0.5, mode 0. This was not statistically significant P = 0.1. Conclusion: While the reduction in CRBSI following tailored advice was not statistically significant, detailed reassessment identified many areas of non adherence suggesting periodic re-evaluation is of use.
Nutricia, Baxter, Pfizer, MSD, Other: Nutricia, K. Majewska: None Declared, D. Kociszewska: None Declared, J. Pałuba: None Declared, I. Foltyn: None Declared, R. Hertz: None Declared, M. Kowalewska: None Declared, M. Omidi: None Declared, J. Kaczanowska: None Declared
Disclosure of Interest: None Declared
Rationale: The common type formula is not able to provide enough energy and protein for the patients in the postoperative first few days. In contrast, when the patients receive the high energy/high protein formula, most patients show high BUN in several days after surgery. To avoid these problems, a new schedule of postoperative early enteral nutrition using two type enteral formulas was tried. Methods: 18 gastric cancer patients who undertook the gastric surgery were enrolled for this trial. 6 patients (trial group) received the high-energy/high-protein formula (1.5 kcal/ml, protein 9.5 g/100 ml) on 1 3 POD, and the common type formula(1.0 kcal/ml, protein 4 g/100 ml) after 4 6POD. 6 patients (high group) received the high energy/high protein formula, and 6 patients (common group) received the common type formula. The velocity of postoperative early enteral nutrition through the jejunostomy is 10 ml/h on 1POD, 20 ml/h on 2POD, 40 ml/h on 3POD, 60 ml/h on 4POD-6POD. Results: The background of the three groups showed no significant difference. N-balance of trial and high group showed positivity on 2POD, however that of common group on 4POD. N-balance of high group was statistically superior to other two groups after 4POD up to 6POD (P < 0.05). BS, ALB, TT levels showed no statistical difference among 3 groups, but high group revealed higher BUN level than trial group on 6POD (P < 0.05). All cases of high group showed high BUN levels more than 20 mg/dl on 6POD. Conclusion: This new schedule of postoperative early enteral nutrition using high energy/high protein formula in postoperative first 3 days and the common type after 4POD showed early positivity of N-balance and stable BUN.
PP199-SUN SYSTEM OR BUNDLES WHERE IS THE KEY FOR PREVENTION CATHETER RELATED BLOOD STREAM INFECTIONS IN HOSPITAL PARENTERAL NUTRITION? M. Pertkiewicz1 , K. Majewska1 , D. Kociszewska2 , J. Pałuba2 , I. Foltyn3 , R. Hertz3 , M. Kowalewska1 , M. Omidi3 , J. Kaczanowska1 . 1 General Surgery and Clinical Nutrition, Medical University of Warsaw, 2 Clinical Bacteriology, 3 General Surgery and Clinical Nutrition, W. Orlowski University Hospital, Warsaw, Poland Rationale: Implementation of catheter care bundles into catheter care has decreased catheter related blood stream infections (CRBSI) rate in ICU, but less or not in other wards with related CRBSI rate between 2 30/1000 PN days [1,2]. It was suggested that higher CRBSI rate is connected with use of compounding bags [2]. Aim was evaluation of CRBSI rate in IFU, where bags are compounded aseptically but not under strict aseptic conditions but several prophylactic measures are obligatory. Methods: Patients records from the last ten years (2003 2012) were reviewed and compared with results of blood cultures collected by Dept. of Clinical Bacteriology. CRBSI rate in two periods, different in approach to line care was compared. In 2003 Jan. 2007 the both peripheral and central lines were cared by all ward nurses after training and from Feb. 2007 new rules were applied, including four levels of approval to care venous access: 0 The strict ban to handle venous access by improperly trained personnel; I peripheral lines only all nurses after training; II central line connection/disconnection PN nurses; III central line therapeutic measures (antibiotic/ethanol lock, blood sampling, reopening blocked catheters etc. after additional training; IV teacher status: gained ability to train staff and patients. Results: The CRBSI rate in the first period was 1.63/ 1000 PN days with rise in January 2007 to 12/1000 PN days, when outside contract nurses were employed and 0.17/ 1000 PN days from Feb. 2007 till Jan. 2013 (OR 0.1, p < 0.001). From 8 CRBSI observed in this time, 4 were related to broken rules of patient preparation for catheter insertion. Conclusion: Line care is critical for avoiding CRBSI and presented system allows for significant decrease CRBSI rate. References [1] Ishikava Y et al., Ann Surg 2010, 251, 620. [2] Pontes-Arruda A et al, Clinical Nutrition 31 (2012), 728 734. Disclosure of Interest: M. Pertkiewicz Grant/Research Support: Nutricia, Consultant for: NPS/Nycomed, Speakers bureau of: BBraun,
PP200-SUN POSTOPERATIVE EARLY ENTERAL NUTRITION USING TWO TYPE ENTERAL FORMULA, HIGH ENERGY/HIGH PROTEIN TYPE AND COMMON TYPE M.J. Maruyama1 . 1 Surgery, Tokyo Metropolitan Ohkubo Hospital, Tokyo, Japan
Disclosure of Interest: None Declared
PP201-SUN LONG-TERM TAUROLIDINE LOCK THERAPY IS MORE EFFECTIVE IN PREVENTING CATHETER RELATED BLOODSTREAM INFECTIONS IN ADULT HOME PARENTERAL NUTRITION PATIENTS THAN HEPARIN: A FOLLOW-UP OF 212 PATIENTS E.D. Olthof1 , G.J. Huisman1 , M.W. Versleijen1 , W. Kievit2 , G.J. Wanten1 . 1 Department of Gastroenterology and Hepatology, 2 Department of Health Evidence, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands Rationale: Home parenteral nutrition (HPN) patients are at risk for developing catheter-related bloodstream infections (CRBSI). In a previous prospective open-label randomized controlled trial in 30 HPN patients presenting with CRBSI we showed that catheter locking with 2% taurolidine dramatically (90%) reduced re-infections compared with low-dose (150