Current status of parenteral nutrition and enteral nutrition application: an assessment of nutritional prescriptions from 59 hospitals in the People’s Republic of China

Abstract

Purpose

The aim of the study reported here was to assess the use of parenteral nutrition (PN) and enteral nutrition (EN), and the prevalence of PN and EN formulas, in the People’s Republic of China.

Methods

Fifty-nine hospitals in the People’s Republic of China participated in a nutrition survey. The resulting information on nutritional support was analyzed.

Results

We received 379,584 nutritional-support prescriptions over 40 days in 2013. PN provided approximately 63.2% and EN provided approximately 36.8% of nitrogen intake. PN provided 63.5% and EN provided 36.5% of lipid intake. There were obvious differences in nitrogen and lipid intake between PN and EN in different regions, departments, and diseases. The percentage of nourishment provided by PN in different regions was highest in Chengdu, followed by the Beijing, Guangzhou, and Hangzhou areas. The percentage of nourishment provided by PN in different departments was highest in general surgery, followed by gastroenterology and the intensive care unit. The percentage of nourishment provided by PN in different diseases/conditions was highest in acute pancreatitis, followed by cancer, and burns. The main source of nitrogen in PN was balanced amino-acid preparations, and in EN, it was protein. The main source of lipids in PN was long- and medium-chain triglyceride lipid emulsion injection.

Conclusion

Despite recent improvements in the application of nutritional support in the People’s Republic of China, a much higher percentage of nitrogen and lipids is delivered through PN than through EN. Furthermore, there are marked regional, departmental, and disease-based differences in the selection of PN versus EN. The rationale for use of nutritional support needs to be improved.

Keywords:

• nutrition survey
• prescription
• nutritional support
• amino-acid preparations
• lipid emulsion

Supplementary materials

Participating hospitals

The following hospitals participated in the study:

The 22 hospitals in the Beijing area were:

• Beijing University People’s Hospital

• Beijing Chuiyangliu Hospital

• Beijing Luhe Hospital

• Beijing Hospital

• Beijing University First Hospital

• Beijing Sixth Hospital

• Beijing Fengtai Hospital

• Beijing Hepingli Hospital

• Beijing Jishuitan Hospital

• Beijing Huaxin Hospital

• Beijing Longfu Hospital

• Beijing Anzhen Hospital

• Beijing Tiantan Hospital

• Beijing Tongren Hospital

• Beijing Xuanwu Hospital

• Beijing Friendship Hospital

• Beijing Zhongguancun Hospital

• China-Japan Friendship Hospital

• Beijing Fangzhuang Hospital

• Beijing Dewai Hospital

• Chinese academy of Medical Sciences Cancer Hospital

• Beijing University Shougang Hospital.

The twelve hospitals in the Chengdu area were:

• West China Hospital of Sichuan University

• Sichuan Provincial People’s Hospital

• The First People’s Hospital of Chengdu

• Affiliated Hospital of North Medical College

• Affiliated Hospital of Chengdu University of Traditional

• Chinese Medicine

• Sichuan Provincial People’s Hospital

• People’s Hospital of Deyang City

• Affiliated Hospital of Chengdu University

• The Second People’s Hospital of Yibin

• The Tenth People’s Hospital of Chengdu

• Building Hospitals of Sichuan Province

• Chengdu Shuangliu People’s Hospital.

The 13 hospitals in the Guangzhou area were:

• The First Affiliated Hospital of Sun Yat-Sen University

• The Third Hospital Affiliated to Sun Yat-Sen University

• Sun Yat-sen University Cancer Center

• The First Affiliated Hospital of Guanzhou Medical University

• The Henan Hospital of Guanzhou Medical University

• Guangdong Provincial People’s Hospital

• The First People’s Hospital of Guangzhou

• Guangzhou Medical School Third Affiliated Hospital

• Guangzhou Overseas Chinese Hospital

• Guangzhou Red Cross Hospital

• The Second Hospital Affiliated to Sun Yat-Sen University

• Guangzhou Dongshan People’s Hospital

• The Eastern Hospital of the First Affiliated Hospital

• Sun Yat-Sen University.

The twelve hospitals in the Hangzhou area were:

• The First Affiliated Hospital of Zhejiang University

• The Second Affiliated Hospital of Zhejiang University

• Zhejiang Provincial People’s Hospital

• Hangzhou Red Cross Hospital

• Zhejiang Cancer Hospital

• Hangzhou Linan People’s Hospital

• Hangzhou Yuhang People’s Hospital

• Hangzhou Jiande People’s Hospital

• Sir Run Run Shaw Hospital of Zhejiang University

• Zhejiang Hospital

• Hangzhou Xiaoshan People’s Hospital

• Zhejiang Provincial Hospital of Traditional Chinese Medicine.

Participating hospitals

The following days were the sampling days in 2013:

• January 1, 14, 22, 28

• February 5, 20, 28

• March 6, 15, 21

• April 8, 17, 23

• May 8, 13, 23, 30

• June 4, 7, 26

• July 2, 10, 26

• August 5, 15, 20, 23

• September 2, 5, 18

• October 10, 21, 25

• November 5, 13, 19, 27

• December 2, 13, 19.

Acknowledgments

The authors would like to thank Professor Li Dakui and his research team on prescription analysis for collecting nutritional-support prescriptions.

Disclosure

The authors report no conflicts of interest in this work.