Last update:
14-Jan-2025

OBJECTIVE The investigation of nursing intervention in surgical patients with feeding weaknesses, submitted in peripheral parenteral nutrition (PPN).

METHOD In the surgical department of a Greek general regional hospital, 111 patients with malnutrition were administered PPN intravenously, from February 2016 to July 2022. Of these, 65 were men and 46 were women, aged 41 to 94 years. Median age was 81 years. The duration of administration was between four and nine days, on average, six days. All patients were evaluated for body mass index (BMI), nutrition and clinical- laboratory criteria. PPN was administered through a peripheral vein via a 22 G catheter, in order to minimize venous wall irritation, by placing a TTS Pancoran 5 mg on it, a venipuncture for continuous vein dilatation. The parenteral solution was administered in 12-16 hours to give an eight hour "rest" of the vein. The purpose of these actions was to avoid the occurrence of osmotic thrombophlebitis and to maintain the vein catheter for 3-4 days.

RESULTS Maddox's grade 1st and 2nd osmotic phlebitis was reported in 32 patients (28.2%). Ten of them required peripheral nutrition to be converted to total parenteral nutrition by a central vein. In 98 patients a positive nitrogen balance was achieved, in nine patients a zero or slightly positive balance was observed, while in the remaining four patients a negative nitrogen balance was observed.

CONCLUSIONS PPN is a perfectly safe way of administering nutrients to any surgical patient with malnutrition. Personalized nursing care prevents the occurrence of osmotic thrombophlebitis and achieves a positive prognosis in patients with PPN, reversing protein catabolism in the majority of cases.

Key words: Nursing intervention, Peripheral parenteral nutrition.