Abstract:
:Background After radical cystectomy, delayed return of bowel function is relatively common. Although studies investigating on the best modality for delivering nutritional support to this patient group are limited, parenteral nutrition was standard of care in those patients at the urological ward of the University Hospitals Leuven. In 2015, we published the findings from our study conducted in patients undergoing elective regular radical cystectomy at the urological ward of the University Hospitals Leuven comparing the length of hospital stay in patients with early postoperative parenteral nutrition (n = 48) versus an immediate oral nutrition protocol (n = 46). It was demonstrated that the implementation of an oral nutrition protocol was associated with a significant reduced length of hospital stay (median [IQR] of 18 [15-22] to 14 [13-18] days (p < 0.001)). The sample size was however too small to investigate the impact of the oral nutrition protocol on the incidence of catheter-related bloodstream infection, a common parenteral nutrition related complication. Objective To investigate the long term impact of an oral nutrition protocol on the incidence of catheter-related bloodstream infection, duration of catheterization and the length of hospital stay. Method Retrospectively, before (parenteral nutrition group) and after the implementation of the oral nutrition protocol (since March 10th 2010), two cohorts of 549 patients who underwent an elective regular radical cystectomy were included. The incidence of a catheter-related bloodstream infection and the length of stay were compared. A central venous catheter was present in every patient, which is standard of care. Results Catheter-related bloodstream infection was reduced from 22 (4%) to 10 (1.8%) (p = 0.031). The median duration of catheterization was 10 [7-13] days for the parenteral nutrition versus 7 [7-7] days for the oral nutrition group (p < 0.001). The median length of stay between both groups, 20 [17-25] before versus 17 [14-21] days after the implementation of the oral nutrition protocol, also differed significantly (p < 0.001). Implementing the oral nutrition protocol resulted in a parenteral nutrition associated cost saving of €470 per patient. Conclusion This large follow-up study showed that the oral nutrition protocol is associated with a reduction in catheter-related bloodstream infection. Besides, postponing parenteral nutrition in favour of oral nutrition enhances recovery.
journal_name
Int J Clin Pharmjournal_title
International journal of clinical pharmacyauthors
Declercq P,Van der Aa F,De Pourcq L,Spriet Idoi
10.1007/s11096-019-00800-ysubject
Has Abstractpub_date
2019-04-01 00:00:00pages
408-413issue
2eissn
2210-7703issn
2210-7711pii
10.1007/s11096-019-00800-yjournal_volume
41pub_type
杂志文章abstract::Background The inclusion of pharmacist in health care system is essential to ensure optimal patient care. However, with the passage of time, pharmacist's role has transcended from dispensing, compounding and counting of pills, to more sophisticated clinical duties. Objective To evaluate doctors' experience, perception...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-00991-9
更新日期:2020-04-01 00:00:00
abstract::Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigate...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,评审
doi:10.1007/s11096-017-0519-2
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:In end-of-life care, symptoms of discomfort are mainly managed by drug therapy, the guidelines for which are mainly based on expert opinions. A few papers have inventoried drug prescriptions in palliative care settings, but none has reported the frequency of use in combination with doses and route of adminis...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0094-3
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abstract::Background In most scenarios, anaesthesiologists titrate opioids to control nociceptive surgical stress based on intraoperative haemodynamic changes. Remifentanil was reported to cause more profound cardiovascular depression than sufentanil. A concern is that this direct cardiovascular depression might counteract the ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01094-1
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:There can be a lack of transfer of information between hospitals and community pharmacies following patient discharge, which puts patients at a high risk of suffering drug related problems (DRPs). Community pharmacy plays a vital role in identifying and solving these discharge DRPs and taking action before t...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-9935-8
更新日期:2014-06-01 00:00:00
abstract::Background Non-adherence to immunosuppressive medications following renal transplantation is a risk factor for rejection and graft loss. Despite the dire consequences, adherence lapses, both unintentional and intentional, are common and poorly understood. Objective The present study sets to compare the rates and deter...
journal_title:International journal of clinical pharmacy
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doi:10.1007/s11096-018-0652-6
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abstract:OBJECTIVE:To evaluate the effects of pharmacotherapy follow-up (PF) on metabolic control and clinical outcomes in type 2 diabetic patients. SETTING:Six community pharmacies (4 intervention and 2 control) in the Curitiba metropolitan region (Brazil). MAIN OUTCOME MEASURE:Glycosylated Haemoglobin A1 (HbA1) and fasting ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-011-9493-2
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:In Europe, parenteral nutrition is often used after radical cystectomy to avoid postoperative malnourishment. To the best of our knowledge, however, there is a paucity of data to conclude on the best modality for delivering nutritional support to this patient group. OBJECTIVE:The parenteral nutrition policy...
journal_title:International journal of clinical pharmacy
pub_type: 临床试验,杂志文章
doi:10.1007/s11096-015-0072-9
更新日期:2015-04-01 00:00:00
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更新日期:2016-12-01 00:00:00
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0360-z
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journal_title:International journal of clinical pharmacy
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-013-9813-9
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Replacement therapy in haemophilia plays an important role in the effective management of this rare bleeding disorder and requires a high level of knowledge and practical skills. OBJECTIVE:To evaluate and to compare the knowledge and skills about the medicines and their management among people with haemophi...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,多中心研究
doi:10.1007/s11096-015-0207-z
更新日期:2016-02-01 00:00:00
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更新日期:2014-04-01 00:00:00
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journal_title:International journal of clinical pharmacy
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更新日期:2014-06-01 00:00:00
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abstract:: ...
journal_title:International journal of clinical pharmacy
pub_type:
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更新日期:2018-02-01 00:00:00
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journal_title:International journal of clinical pharmacy
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
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更新日期:2012-12-01 00:00:00
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