TY - JOUR
T1 - Proactive enteral nutrition for patients undergoing allogeneic stem cell transplantation- implementation and clinical outcomes
AU - Andersen, Sarah
AU - Fichera, Rebecca
AU - Banks, Merrilyn
AU - Brown, Teresa
AU - Kennedy, Glen
AU - Weber, Nicholas
AU - Williams, David
AU - Bauer, Judy
N1 - Funding Information:
This research was supported by grants from the Royal Brisbane & Women’s Hospital Research Foundation. The funding body has no role in the study design, data collection, analysis, interpretation or in the manuscript preparation.
Publisher Copyright:
© 2023, Crown.
PY - 2023
Y1 - 2023
N2 - Background/ Objectives: Nutrition support is frequently required post allogeneic haematopoietic progenitor cell transplantation (HPCT) however the tolerance of enteral nutrition (EN) can vary. This mixed methods study aimed to explore staff perceptions, barriers and enablers to the use of EN post HPCT and report the implementation and outcomes of a nutrition protocol. Subject/ Methods: A survey on barriers and enablers to the use of EN was developed and distributed to medical and nursing staff. Data on nutrition and clinical outcomes was collected for 12 months post implementation of a new nutrition protocol. Results: Thirty staff completed the survey, key barriers identified included uncertain EN tolerance, lack of confidence in nasogastric tube placement and insufficient training and resources. Eighty-four patients commenced EN, 23 changed to PN (27%) and 61 received EN only (73%). In total 36 patients received PN and eight patients oral nutrition support only. There was a difference in type of conditioning (p = 0.025) and nutritional status (p = 0.016) between patients who received PN vs EN only, with a higher proportion of malnourished patients receiving PN (23% vs 5%). Patients who received PN had a longer length of hospital stay (median 22 vs 19 days, p = 0.012) and lower rate of survival to day 100 (81% vs 95%, p = 0.036) than patients who received EN. Conclusion: The use of EN may lead to improved clinical outcomes compared to PN therefore should be implemented as first line nutrition support.
AB - Background/ Objectives: Nutrition support is frequently required post allogeneic haematopoietic progenitor cell transplantation (HPCT) however the tolerance of enteral nutrition (EN) can vary. This mixed methods study aimed to explore staff perceptions, barriers and enablers to the use of EN post HPCT and report the implementation and outcomes of a nutrition protocol. Subject/ Methods: A survey on barriers and enablers to the use of EN was developed and distributed to medical and nursing staff. Data on nutrition and clinical outcomes was collected for 12 months post implementation of a new nutrition protocol. Results: Thirty staff completed the survey, key barriers identified included uncertain EN tolerance, lack of confidence in nasogastric tube placement and insufficient training and resources. Eighty-four patients commenced EN, 23 changed to PN (27%) and 61 received EN only (73%). In total 36 patients received PN and eight patients oral nutrition support only. There was a difference in type of conditioning (p = 0.025) and nutritional status (p = 0.016) between patients who received PN vs EN only, with a higher proportion of malnourished patients receiving PN (23% vs 5%). Patients who received PN had a longer length of hospital stay (median 22 vs 19 days, p = 0.012) and lower rate of survival to day 100 (81% vs 95%, p = 0.036) than patients who received EN. Conclusion: The use of EN may lead to improved clinical outcomes compared to PN therefore should be implemented as first line nutrition support.
UR - http://www.scopus.com/inward/record.url?scp=85176590746&partnerID=8YFLogxK
U2 - 10.1038/s41430-023-01367-8
DO - 10.1038/s41430-023-01367-8
M3 - Article
C2 - 37968417
AN - SCOPUS:85176590746
SN - 0954-3007
VL - 78
SP - 251
EP - 256
JO - European Journal of Clinical Nutrition
JF - European Journal of Clinical Nutrition
ER -
