ArticleCureus2026
Audit of Parenteral Nutrition Use in Surgical Patients: Compliance With the 2017 American Society for Parenteral and Enteral Nutrition Guidelines.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
Background Prospective data on parenteral nutrition (PN) practices in surgical patients from India are limited. Auditing PN use with respect to indications, administration patterns, vascular access, monitoring, and complications provides insight into current clinical practice. Objectives To evaluate the adherence of PN practices at our institution to the 2017 American Society for Parenteral and Enteral Nutrition (ASPEN) guideline recommendations. Methods A hospital-based prospective observational study was conducted in the department of general surgery between April 2019 and April 2020. Adult patients who received PN and provided informed consent were enrolled consecutively. Data on patient demographics, indications for PN, patterns of use, vascular access, monitoring practices, complications, and clinical outcomes were collected prospectively from case records, the hospital information system (HIS), and the picture archiving and communication system (PACS). Categorical variables were summarized as frequencies and percentages, whereas continuous variables were summarized as the mean ± standard deviation or median with interquartile range (IQR), as appropriate. PN practices were assessed against the 2017 ASPEN guideline recommendations. Results Forty-seven patients met the inclusion criteria. The most common indications for PN were postoperative anastomotic leak (11 patients) and enterocutaneous fistula (10 patients). The median PN duration was seven days (IQR, 4.5-11.5 days). Before PN initiation, the central venous catheter tip position was radiologically confirmed in 40 patients, and 43 patients underwent risk assessment for refeeding syndrome. Daily monitoring of the catheter insertion site, vital signs, and fluid intake and output was performed, whereas body weight and nutritional requirements were reassessed weekly. Dysglycemia occurred in 34 patients, and blood glucose monitoring was less frequent than recommended by the ASPEN guidelines. Hyponatremia (78.72%), hypomagnesemia (78.72%), and hyperglycemia (72.34%) were the most common metabolic complications. Catheter-related bloodstream infection occurred in 11 patients, fungemia in three, and pneumothorax in one. Conclusion PN practices at our institution demonstrated substantial adherence to the 2017 ASPEN guideline recommendations. However, important gaps remained in central venous catheter care documentation and blood glucose monitoring, highlighting opportunities to improve the quality and safety of PN delivery through enhanced documentation and adherence to guideline-recommended monitoring practices.
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