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Short report
Parenteral nutrition in palliative care: single-centre observational study
  1. Clara Berbée1,
  2. Jan Philipp Marx2,
  3. Maria Theresa Voelker2,
  4. Dörte Schotte2 and
  5. Sven Bercker2
  1. 1 Department of Gynaecology, Leipzig University Hospital, Leipzig, Germany
  2. 2 Anesthesiology and Critical Care Medicine, Leipzig University Hospital, Leipzig, Sachsen, Germany
  1. Correspondence to Clara Berbée; clara.berbee{at}medizin.uni-leipzig.de

Abstract

Objective Cachexia and nutritional problems play a major role in palliative care. Artificial nutrition such as parenteral nutrition is common but its role and indications in terminal patients remain controversial due to lack of data. Therefore, recommendations are vague. Benefits and risks of parenteral nutrition in palliative care as well as the clinical implementation of the guidelines have not been adequately studied yet.

Methods In this single-centre observational study, 72 palliative care patients were followed for 1 month. Patients with and without parenteral nutrition were analysed regarding venous access complications, oedema, weight and health-related quality of life.

Results 93% of all patients showed reduced food intake. 34 (47%) patients received parenteral nutrition. Parenteral nutrition reduced energy deficit but was not associated with quality of life. Complications with the venous accesses for parenteral nutrition were frequent. A relevant proportion of patients with planned parenteral nutrition received no or only a few days of parenteral nutrition. Moreover, patients with parenteral nutrition showed more frequent and pronounced oedema.

Conclusion The benefit–risk balance of palliative parenteral nutrition in end-of-life treatment seems to be questionable. In view of the identified risks, parenteral nutrition in end-of-life care should be initiated with caution.

  • end of life care
  • hospice care
  • quality of life
  • supportive care
  • cachexia
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjspcare-2022-003581

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    Footnotes

    • Contributors CB collected data. CB, SB, JPM and MTV wrote the manuscript. All authors approved and finalised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.