Overfeeding linked to CLABSI in hospitalized patients on parenteral nutrition

17 Sep 2023
Overfeeding linked to CLABSI in hospitalized patients on parenteral nutrition

Overfeeding, but not underfeeding, appears to be the reason for the increased risk for central line-associated bloodstream infection (CLABSI) in hospitalized adult patients receiving parenteral nutrition (PN), suggests a recent study.

Twenty-nine patients with CLABSI were compared with 274 control participants. CLABSI was significantly more likely to develop in patients receiving greater than 30 kcal/kg/day (odds ratio [OR], 3.63, 95 percent confidence interval [CI], 1.55‒8.48; p<0.01).

No significant difference was observed in the likelihood of CLABSI development among patients receiving less than 20 kcal/kg/day (OR, 0.74, 95 percent CI, 0.21‒2.57; p=0.63).

“These results may aid clinicians in the management of patients requiring PN and in the generation of hypothesis for future investigations,” the authors said.

This case-control study was conducted in a single United States Veterans Health Administration health system to explore the potential CLABSI risk factor of weight-based PN kilocalorie dosing.

The authors identified hospitalized adult patients who developed CLABSI while receiving PN and compared these to a control group of patients who did not develop CLABSI. Subsequently, they assessed the following exposures: overfeeding (defined as greater than 30 kcal/kg/day) and underfeeding (defined as less than 20 kcal/kg/day).

“CLABSI is a complication of central venous access devices used for PN,” the authors said. “PN overfeeding is associated with increased adverse effects.”

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