Seguimiento farmacoterapéutico en pacientes adultos que reciben nutrición parenteral y enteral atendidos en el Hospital General “Teófilo Dávila”

Abstract

Parenteral and enteral nutrition are two different ways of providing nutrients to patients who cannot receive the necessary nutritional requirements through oral intake. In the Intensive Care Unit of a Hospital, it is mainly the service where critical patients who are unable to absorb nutrients through the gastrointestinal tract are cared for, therefore, they resort to parenteral nutrition through the central or peripheral route and in certain cases via enteral via a nasogastric tube. The objective of this research is to determine the problems related to medications in adult patients receiving parenteral and enteral nutrition treated in the intensive care unit (ICU) of the “Teófilo Dávila” General Hospital through pharmacotherapeutic monitoring. For this reason, a prospective investigation is developed based on documentary and field analysis of medical records and medication prescriptions in patients with parenteral and enteral nutrition. The Dáder method was used, which consists of seven stages, which allowed us to collect the required information. 26 patients were studied in the ICU area with an average age of 42.8 years, the male sex prevailed with 57.7%. Parenteral nutrition was used in 38.4% of patients. The most frequent diagnosis for admission to the ICU was unspecified pneumonia (J189) and tertiary peritonitis (K65.9). The most used medications were 0.9% sodium chloride, omeprazole and paracetamol. In addition to this, 158 prescriptions were analyzed, of which 40.5% were for parenteral nutrition, and 34.6% of PRM 3 were found in the patients, where it was possibly due to interactions between medications, the most common interactions being those between furosemide + calcium gluconate, omeprazole + midazolam and omeprazole + fluconazole. On the other hand, non-compliance with lipid nutritional requirements was observed in 19.6% of prescriptions, which were compared by the recommendations given by ASPEN. Also, it was completed with a proposal for the creation of a mixing center calculating the Pay-back of 5 years and a positive NPV. We can conclude that pharmacotherapeutic monitoring is essential for controlling the therapy and nutrition received by patients in critical condition, thereby optimizing their treatment through individualized attention for correct administration of parenteral and enteral nutrition and medications in order to improve their condition. quality of life.