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A double-blind randomized trial comparing outpatient parenteral nutrition with intravenous hydration: effect on resumption of oral intake after marrow transplantation.

Publication ,  Journal Article
Charuhas, PM; Fosberg, KL; Bruemmer, B; Aker, SN; Leisenring, W; Seidel, K; Sullivan, KM
Published in: JPEN J Parenter Enteral Nutr
1997

BACKGROUND: Outpatient parenteral nutrition (PN) is often given to marrow transplant recipients after high-dose chemoradiotherapy until the resumption of adequate oral intake; however, it may adversely prolong resumption or oral calorie intake by contributing to early satiety. METHODS: A double-blind, randomized study compared standard PN (final concentration 25% dextrose, 5% amino acids) with a hydration solution (5% dextrose) during the first 28 days of outpatient treatment. Patients were eligible for the study if they were > or = 2 years of age, < 65 days posttransplant, had < 70% oral caloric intake at hospital discharge, and required < or = 10 U insulin/L PN. Solutions were provided until the patient's oral intake met > or = 85% caloric requirements for 3 consecutive days. RESULTS: Two hundred fifty-eight marrow transplant recipients (128, PN and 130, hydration solution) were studied. Age, donor type, and diagnoses were similar in the two groups. Time to resumption of > or = 85% oral caloric intake was 6 days sooner in the hydration group than in the PN group (median 10 vs 16 days, respectively; p = .049). When adjusting for sex, age, donor type, total body irradiation, previous oral intake, acute graft-versus-host disease, and prednisone therapy, the hydration group resumed oral intake sooner than the PN group (relative risk = 1.51; 95% confidence interval [CI] 1.04 to 2.19; p = .029). The percentage of weight change from pretransplant values, adjusted for the above covariates and the number of weeks of treatment, indicated that the hydration solution group lost weight (4.63%) compared with the PN group (1.27%) after 4 weeks of therapy (p = .004). Rates of hospital readmissions, relapse of malignancy, and survival did not differ between the two treatment groups. CONCLUSIONS: We conclude that outpatient PN delays resumption of oral intake and that its replacement with hydration solution does not result in adverse patient outcome.

Duke Scholars

Published In

JPEN J Parenter Enteral Nutr

DOI

ISSN

0148-6071

Publication Date

1997

Volume

21

Issue

3

Start / End Page

157 / 161

Location

United States

Related Subject Headings

  • Weight Loss
  • Time Factors
  • Parenteral Nutrition, Home
  • Nutrition & Dietetics
  • Male
  • Humans
  • Fluid Therapy
  • Female
  • Energy Intake
  • Eating
 

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Charuhas, P. M., Fosberg, K. L., Bruemmer, B., Aker, S. N., Leisenring, W., Seidel, K., & Sullivan, K. M. (1997). A double-blind randomized trial comparing outpatient parenteral nutrition with intravenous hydration: effect on resumption of oral intake after marrow transplantation. JPEN J Parenter Enteral Nutr, 21(3), 157–161. https://doi.org/10.1177/0148607197021003157
Charuhas, P. M., K. L. Fosberg, B. Bruemmer, S. N. Aker, W. Leisenring, K. Seidel, and K. M. Sullivan. “A double-blind randomized trial comparing outpatient parenteral nutrition with intravenous hydration: effect on resumption of oral intake after marrow transplantation.JPEN J Parenter Enteral Nutr 21, no. 3 (1997): 157–61. https://doi.org/10.1177/0148607197021003157.
Charuhas PM, Fosberg KL, Bruemmer B, Aker SN, Leisenring W, Seidel K, et al. A double-blind randomized trial comparing outpatient parenteral nutrition with intravenous hydration: effect on resumption of oral intake after marrow transplantation. JPEN J Parenter Enteral Nutr. 1997;21(3):157–61.
Charuhas, P. M., et al. “A double-blind randomized trial comparing outpatient parenteral nutrition with intravenous hydration: effect on resumption of oral intake after marrow transplantation.JPEN J Parenter Enteral Nutr, vol. 21, no. 3, 1997, pp. 157–61. Pubmed, doi:10.1177/0148607197021003157.
Charuhas PM, Fosberg KL, Bruemmer B, Aker SN, Leisenring W, Seidel K, Sullivan KM. A double-blind randomized trial comparing outpatient parenteral nutrition with intravenous hydration: effect on resumption of oral intake after marrow transplantation. JPEN J Parenter Enteral Nutr. 1997;21(3):157–161.
Journal cover image

Published In

JPEN J Parenter Enteral Nutr

DOI

ISSN

0148-6071

Publication Date

1997

Volume

21

Issue

3

Start / End Page

157 / 161

Location

United States

Related Subject Headings

  • Weight Loss
  • Time Factors
  • Parenteral Nutrition, Home
  • Nutrition & Dietetics
  • Male
  • Humans
  • Fluid Therapy
  • Female
  • Energy Intake
  • Eating