Parenteral Nutrition-Associated Sepsis and Extravasation in Iraqi Neonates: Case-Series Prospective Study

Authors

  • Dalya Abdul Kareem Mohammed Neonatal Intensive Care Unit, Children Welfare Teaching Hospital, Medical City, Baghdad, Iraq
  • Yasir Ibrahim Abdulridha Neonatal Intensive Care Unit, Children Welfare Teaching Hospital, Medical City, Baghdad, Iraq
  • Mustafa Ghazi Alabbassi Department of Pharmacology and Toxicology, College of Pharmacy, University of Alkafeel, Najaf, Iraq
  • Saad Abdulrahman Hussain Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Rafidain University College, Baghdad 10052, Iraq https://orcid.org/0000-0002-1909-417X

DOI:

https://doi.org/10.54133/ajms.v6i1.458

Keywords:

Extravasation, Intensive care, Neonates, Parenteral nutrition, Sepsis

Abstract

Background: Extravasation and sepsis are two of the many side effects linked to the use of intravascular devices during parenteral nutrition (PN). Objective: To assess the incidence of sepsis and extravasation in Iraqi neonates receiving PN in the critical care unit. Methods: From January 27, 2022, to January 15, 2023, a case-series prospective study was carried out in two tertiary neonatal intensive care units (NICUs) in Children Welfare Hospital and Baghdad Teaching Hospital, Baghdad, Iraq. The study reports the rate of sepsis and extravasations and correlates their occurrence to other neonatal features. Results: Of the 94 newborns examined, 24 patients (25.5%) experienced 35 instances of stage IV extravasation, and 34.04% of them experienced 40 episodes of sepsis in total. They have a strong and significant correlation with the newborns' body weight, treatment duration, gestational age, and postnatal age. Conclusions: The administration of PN to neonates in Iraq has been linked to severe side effects such as sepsis and extravasation.

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References

Worthington P, Balint J, Bechtold M, Bingham A, Chan LN, Durfee S, et al. When Is Parenteral Nutrition Appropriate? J Parenter Enteral Nutr. 2017;41(3):324-377. doi: 10.1177/0148607117695251.

Colomb V. Commercially premixed 3-chamber bags for pediatric parenteral nutrition are available for hospitalized children. J Nutr. 2013;143(12 Suppl):2071S-2076S. doi: 10.3945/jn.113.176974.

Mihatsch W, Fewtrell M, Goulet O, Molgaard C, Picaud JC, Senterre T. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Calcium, phosphorus and magnesium. Clin Nutr. 2018;37(6 Pt B):2360-2365. doi: 10.1016/j.clnu.2018.06.950.

Mehta NM, Skillman HE, Irving SY, Coss-Bu JA, Vermilyea S, Farrington EA, et al. Guidelines for the provision and assessment of nutrition support therapy in the pediatric critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. J Parenter Enteral Nutr. 2017;41(5):706-742. doi: 10.1177/0148607117711387.

Duck S. Neonatal intravenous therapy. J Intraven Nurs. 1997;20(3):121-8. PMID: 9214923.

Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. Lancet 2012;379:2162–2172. doi: 10.1016/S0140-6736(12)60820-4.

Lloyd LG, Bekker A, Van Weissenbruch MM, Dramowski A. Healthcare-associated infections in very low birth-weight infants in a South African neonatal unit: Disease burden, associated factors and short-term outcomes. Pediatr Infect Dis J. 2022;41(11):911-916. doi: 10.1097/INF.0000000000003666.

Ratchagame V, Prabakaran V. Comparison of risks from central venous catheters and peripheral intravenous lines among term neonates in a tertiary care hospital, India. J Caring Sci. 2021;10(2):57-61. doi: 10.34172/jcs.2021.012.

Mireya UA, Martí PO, Xavier KV, Cristina LO, Miguel MM, Magda CM. Nosocomial infections in paediatric and neonatal intensive care units. J Infect. 2007;54(3):212-220. doi: 10.1016/j.jinf.2006.03.023.

Hartman C, Shamir R, Simchowitz V, Lohner S, Cai W, Decsi T, et al. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Complications. Clin Nutr. 2018;37(6):2418-2429. doi: 10.1016/j.clnu.2018.06.956.

Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics. 2002;110(2 Pt 1):285-291. doi: 10.1542/peds.110.2.285.

Zingg W, Posfay-Barbe KM, Pfister RE, Touveneau S, Pittet D. Individualized catheter surveillance among neonates: a prospective, 8-year, single-center experience. Infect Control Hosp Epidemiol. 2011;32(1):42-49. doi: 10.1086/657634.

Geffers C, Baerwolff S, Schwab F, Gastmeier P. Incidence of healthcare-associated infections in high-risk neonates: results from the German surveillance system for very-low-birthweight infants. J Hosp Infect. 2008;68(3):214-221. doi: 10.1016/j.jhin.2008.01.016.

Chaudhari S, Kadam S. Total parenteral nutrition in neonates. Indian Pediatr. 2006;43(11):953-964. PMID: 17151398.

Zingg W, Pittet D. Peripheral venous catheters: an under-evaluated problem. Int J Antimicrob Agents. 2009;34 Suppl 4:S38-42. doi: 10.1016/S0924-8579(09)70565-5.

Gregory KE. Update on nutrition for preterm and full-term infants. J Obstet Gynecol Neonatal Nurs. 2005;34(1):98-108. doi: 10.1177/0884217504272805.

Johnson MJ, Lapillonne A, Bronsky J, Domellof M, Embleton N, Iacobelli S, et al. Research priorities in pediatric parenteral nutrition: a consensus and perspective from ESPGHAN/ESPEN/ESPR/CSPEN. Pediatr Res. 2022;92(1):61-70. doi: 10.1038/s41390-021-01670-9.

Blackmer AB, Partipilo ML. Three-in-one parenteral nutrition in neonates and pediatric patients: risks and benefits. Nutr Clin Pract. 2015;30(3):337-343. doi: 10.1177/0884533615580596.

Saeedi M, Mohajerani S, Mohsenipour R. The complications of total parenteral nutrition and the contributing factors in children in Tehran, Iran. Int J Nutr Sci. 2022;7(2):94-99. doi: 10.30476/IJNS.2022.94960.1183.

Beganovic N, Verloove-Vanhorick SP, Brand R, Ruys JH. Total parenteral nutrition and sepsis. Arch Dis Child. 1988;63(1):66-67. doi: 10.1136/adc.63.1.66.

Soussi MA, Besbes H, Mellouli F, Drira C, Lazreg O, Belghith A, et al. Parenteral nutrition complications in children undergoing bone marrow transplantation. J Pediatr Hematol Oncol. 2019;41(7):E473-477. doi: 10.1097/MPH.0000000000001560.

Lapillonne A, Fidler Mis N, Goulet O, van den Akker CHP, Wu J, Koletzko B. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Lipids. Clin Nutr. 2018;37(6 Pt B):2324-2336. doi: 10.1016/j.clnu.2018.06.946.

Suganuma H, Bonney D, Andersen CC, McPhee AJ, Sullivan TR, Gibson RA, et al. The efficacy and safety of peripheral intravenous parenteral nutrition vs 10% glucose in preterm infants born 30 to 33 weeks’ gestation: A randomized controlled trial. BMC Pediatr. 2020;20(1):384. doi: 10.1186/s12887-020-02280-w.

Danski MTR, Mingorance P, Johann DA, Vayego SA, Lind J. Incidence of local complications and risk factors associated with peripheral intravenous catheter in neonates. Rev Esc Enferm USP. 2016;50(1):22-28. doi: 10.1590/S0080-623420160000100003.

Worth LJ, Daley AJ, Spelman T, Bull AL, Brett JA, Richards MJ. Central and peripheral line-associated bloodstream infections in Australian neonatal and pediatric intensive care units: findings from a comprehensive Victorian surveillance network, 2008–2016. J Hosp Infect. 2018;99(1):55-61. doi: 10.1016/j.jhin.2017.11.021.

Yew CK, Mat Johar SFN, Lim WY. Case series of neonatal extravasation injury: Importance of early identification and management. Cureus. 2022;14(1):e21179. doi: 10.7759/cureus.21179.

van Puffelen E, Vanhorebeek I, Joosten KFM, Wouters PJ, Van den Berghe G, Verbruggen SCAT. Early versus late parenteral nutrition in critically ill, term neonates: a preplanned secondary subgroup analysis of the PEPaNIC multicenter, randomized controlled trial. Lancet Child Adolesc Heal. 2018;2(7):505-515. doi:10.1016/S2352-4642(18)30131-7.

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Published

2024-01-24

How to Cite

Mohammed, D. A. K., Abdulridha , Y. I., Alabbassi, M. G., & Hussain, S. A. (2024). Parenteral Nutrition-Associated Sepsis and Extravasation in Iraqi Neonates: Case-Series Prospective Study. Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ), 6(1), 91–96. https://doi.org/10.54133/ajms.v6i1.458

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