COMPLETE PARENTERAL NUTRITION IN CHILDREN WITH MALIGNANT DISEASES TREATED IN THE PEDIATRIC CLINIC OF THE CLINICAL HOSPITAL CENTER RIJEKA

Prehrana je važna komponenta potporne terapije u djece s malignim bolestima. Proteinsko energetska malnutricija udružena je sa slabijim podnošenjem antitumorske terapije, smanjenom imunološkom otpornosti, mijelosupresijom, duljom hospitalizacijom i lošijim ishodom liječenja. Parenteralna prehrana je indicirana u stanjima u kojima oralna i enteralna potpora ne zadovoljava nutritivne potrebe organizma. Cilj rada je prikazati institucionalna iskustva u primjeni parenteralne prehrane u djece i adolescenata s malignim bolestima koji su u razdoblju od 1. lipnja 2013. do 1. lipnja 2018. godine liječeni na Zavodu za hematologiju, onkologiju i kliničku genetiku Klinike za pedijatriju Kliničkog bolničkog centra Rijeka. Potpuna parenteralna prehrana (PPP) je provedena u 41 pacijenta (23 dječaka i 18 djevojčica), s ukupno 99 primjena (2,4 primjene po pacijentu). Prosječna dob ispitanika je iznosila 8,4 ±5,6 godina. Najčešće indikacije za primjenu PPP su bile gubitak tjelesne mase, oralni mukozitis, paralitički ileus i nemogućnost peroralnog unosa. U svih ispitanika PPP je primijenjena putem centralnog venskog katetera. Prosječno trajanje PPP iznosilo je 7,1 ± 4,8 dana. U ispitanika je zabilježen statistički značajan porast tjelesne mase. Komplikacije su zamijećene u 3% primjena (porast transaminaza i hipertrigliceridemija). PPP je učinkovita metoda nutritivne potpore pedijatrijskih onkoloških bolesnika. Komplikacije su vrlo rijetke i blage.Nutrition is an important component of supportive therapy in children with cancer. Protein-energy malnutrition is associated with lower tolerance to antineoplastic treatment, decreased immune resistance, myelosuppression, prolonged hospitalization, and poorer treatment outcome. Parenteral nutrition is indicated in conditions in which oral and enteral support does not meet the nutritional needs of the body. The aim of this study is to present institutional experiences in the parenteral nutrition in children and adolescents with malignant diseases who were treated at the Division of Hematology, Oncology and Clinical Genetics, Department of Pediatrics, Clinical Hospital Center Rijeka, in the period from June 1st 2013 to June 1st 2018. Total parenteral nutrition (TPN) was performed in 41 patients (23 boys and 18 girls), with a total of 99 applications (2.4 applications per patient). The mean age of the subjects was 8.4 ± 5.6 years. The most common indications for TPN were weight loss, oral mucositis, paralytic ileus, and inability to oral intake. In all subjects, central venous catheters were used to administer TPN. The average duration of TPN was 7.1 ± 4.8 days. A statistically significant increase in body weight was recorded in the study. Complications were present in 3% of applications (elevated transaminase levels and hypertriglyceridemia). TPN is an effective method of nutritional support for pediatric oncology patients. Complications are very rare and mild