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Safety of Intravenous Hyperalimentation in Children with Malignancies: A Cooperative Group Trial
Author(s) -
Van Eys Jan,
Wesley Margaret N.,
Cangir Ayten,
Copeland Edward M.,
Donaldson Sarah S.,
Ghavimi F.,
Shils Maurice,
Suskind Robert,
Jaffe Norman,
Filler Robert
Publication year - 1982
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607182006004291
Subject(s) - medicine , randomized controlled trial , randomization , pleural effusion , surgery
A prospective randomized cooperative trial of intravenous hyperalimentation (IVH) was executed in children with malignancies in two segments: those patients who are newly diagnosed and who would undergo abdominal irradiation, and patients with tumors that were metastatic to or from bone. The combined experience was pooled to evaluate the safety of IVH in these children with cancer. Patients who were not malnourished were randomized to receive IVH or regular diets. Malnutrition was defined by a weight for height below the 80th percentile of the median for age and sex and/or serum albumin below 3.0 grams per 100 milliliter. Patients falling below such standards were given IVH as nonrandomized entries in the study. Twenty‐three were randomized to IVH, 25 randomized to control, and 18 entered on IVH without randomization, for a total patient entry of 66. No incidence of pneumothorax or local infections at the catheter insertion site were seen. Among the patients randomized to IVH, no local infections were found at the catheter insertion site. One hemothorax occurred and one hematoma was seen. In patients who were malnourished, one insertion site infection occurred and two hematomas were seen. Volume overload was compared between the randomized patients. Among randomized patients, ascites occurred once on IVH and none in controls, whereas congestive heart failure did not occur on IVH but twice in controls. Abnormal blood ammonia was seen in two randomized IVH patients and in none of the control, altered electrolyte balance was seen once in both control and IVH groups as was symptomatic hyperglycemia. The infectious complications in patients who got abdominal irradiation showed more fever in patients randomized to IVH, but no documented infections. In the sicker children who had metastatic disease, there were three infections in controls and five in patients on IVH. These results showed that IVH is safe and acceptable in children with cancer, and that complications, which might readily have been attributable to IVH, were seen in both controls and IVH patients when compared in a randomized prospective fashion.