Nutrition. 2026 May 19;150:113294. doi: 10.1016/j.nut.2026.113294. Online ahead of print.
ABSTRACT
INTRODUCTION: Patients hospitalized with respiratory diseases are at high risk of nutritional deterioration due to increased metabolic demands and systemic inflammation. When enteral nutrition is not feasible, parenteral nutrition (PN) becomes necessary; however, evidence in respiratory referral centers remains limited. This study aimed to characterize the indications, timing, and clinical outcomes of PN, with emphasis on metabolic complications.
METHODS: A retrospective analysis of prospectively collected data was conducted in a tertiary respiratory referral hospital between September 2023 and December 2024. Adults (≥18 y) receiving PN for >2 d were included. Clinical characteristics, indications, timing of PN initiation, nutritional delivery, and metabolic complications were evaluated. PN-associated liver dysfunction and electrolyte disturbances were defined using standardized criteria. Descriptive statistics were applied.
RESULTS: Eighty-two patients were included (54.9% male; mean age 55.6 ± 15.8 y); 79.3% were at nutritional risk on admission. PN was initiated at a median of 4 (1-13) d, mainly due to gastrointestinal dysfunction and hemodynamic instability (31.7% each). Total PN predominated (82.9%), and 57.3% received combined enteral and parenteral nutrition. Nutritional delivery increased stepwise, reaching 31.9 kcal/kg/d and 1.5 g/kg/d of protein by day 7. Glycemic control remained stable, and triglycerides did not exceed critical thresholds. Hypokalemia was the most frequent electrolyte disturbance (36.1% at day 7), while phosphorus and magnesium remained stable. Liver enzyme elevations appeared more related to disease severity than PN.
CONCLUSION: PN was frequently initiated in the context of gastrointestinal dysfunction and hemodynamic instability, often with delayed timing. A structured approach based on gradual nutrient delivery and close monitoring was associated with a low incidence of severe metabolic complications, underscoring the importance of individualized nutritional management.
PMID:42284623 | DOI:10.1016/j.nut.2026.113294
