Case study illustrates complications of peripheral parenteral nutrition

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#IVTEAM #Intravenous literature: Tomàs Tomàs, M.M., Pérez Juan, E. and Amorós Cerdá, S.M. (2013) Complications of peripheral parenteral nutrition. Clinical observations of 2 cases. [Article in Spanish]. Enfermería Intensiva. December 16th. [epub ahead of print].

Abstract:

INTRODUCTION: Peripheral parenteral nutrition (PPN) is artificial nutrition used when digestive absorption is insufficient. It supplies the nutritional needs of the patient and permits administration through a peripheral catheter.

WE PRESENT 2 CLINICAL CASES: The first one entails an epidermolisis through extravasation masked by temporo-spatial disorientation of the patient with appearance of flictenes (blisters). Prolonged treatment and consultation with plastic surgery were required. The second case entails a chemical phlebitis with early detection by nursing professionals. It was resolved with short term treatment and did not require consultation with the plastic surgeon.

PLANNING CARE: We elaborated a care plan aimed at identifying real or potential problems related with possible complications of intravenous PPN administration, such as phlebitis and extravasation. The aim of this research was prevention, early detection and treatment.

DISCUSSION: Phlebitis is related with catheter characteristics, in-dwelling time and high osmolarity of PPN. Early action decreases injury of the affected tissue. In case 1, the patient requires 19 days of curing. This was only 72h in case 2.

CONCLUSION: The nursing staff plays an essential role in catheter election, localization, administration and preventing complications. Staff training and a procedure protocol greatly reduce the incidence of phlebitis, avoid discomfort for the patient and reduce health care cost.

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