The Complications of Total Parenteral Nutrition and the Contributing Factors in Children in Tehran, Iran

Total parenteral nutrition (TPN) is used to maintain the nutritional status of children in surgical wards which is essential not only for patients’ recovery, but also for normal growth and development. Given the high prevalence of TPN in the surgical wards, the present study was designed to investigate the short-term complications of TPN and the factors affecting in children’s medical center, in Tehran, Iran. Methods: In a retrospective cross-sectional study, all records of patients who underwent TPN in surgery wards of the children’s medical center of Tehran, Iran between 2017 and 2020 were enrolled. Demographic and baseline data including sex, age and also type of surgery, duration of TPN, TPN content, and short-term complications were analyzed. Results: one hundred and forty-five children including 97 males (66.9%) and 48 females (33.1%) were enrolled. Female patients had a significantly higher rate of central line-associated bloodstream infections (CLABSI, p=0.03). The duration of TPN was significantly correlated with the incidence of glucose disturbances (p=0.012), metabolic acidosis (p=0.05), potassium disturbances (p=0.03), liver disorders (p=0.001), dehydration (p=0.002), and CLABSI (p=0.002). The age of the patients was also significantly associated with the prevalence of potassium disturbances (p<0.001), liver complications (p<0.001), and positive blood culture (p=0.001). TPN content was not significantly associated with complications. Conclusion: Long-term TPN was shown to increase the risks of various metabolic diseases and CLABSI. Monitoring of electrolytes levels, liver function, and other health status aspects is necessary for the patient under prolonged TPN.