Muscle cramps are the commonest side effect of home parenteral nutrition

• Published in: Clinical nutrition (Edinburgh, Scotland) Scotland), 2009-06, Vol.28 (3), p.351-354
• Main Authors: Elphick, D.A, Baker, M, Baxter, J.P, Nightingale, J.M.D, Bowling, T, Page, K.B, McAlindon, M.E
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Case-Control Studies; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Home parenteral nutrition; Humans; Intensive care medicine; Male; Medical sciences; Middle Aged; Muscle Cramp - epidemiology; Muscle Cramp - etiology; Muscle cramps; Parenteral Nutrition, Home - adverse effects; Prevalence; Quality of Life; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Water-Electrolyte Balance - physiology; Young Adult
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2009.02.008

Summary Background & aims Complications resulting from home parenteral nutrition (HPN) reduce a patient's quality of life. The major complications of catheter-related sepsis, venous thrombosis and chronic liver disease are well recognised. This study aimed to determine if there were other minor, but common complications that caused patient distress. Methods All patients (45) from four HPN centres were asked if they had suffered any side effects of parenteral nutrition and whether these side effects related to the timings of the feed or required specific intervention. Results Muscle cramps were the most common minor side effect [12/45 (27%)]. A greater proportion of HPN patients (51%) suffered from muscle cramps than did a control group of patients with inflammatory bowel disease (24%) [ p = 0.0001]. In the HPN patients, no significant difference in serum electrolyte concentration or in feed composition was noted between those patients with and those without cramps in relation to feeds. Cramps were of sufficient severity to warrant pharmacological intervention in 9 of 12 patients who had cramps in relation to feeds, and parenteral nutrition administration was slowed in 2 of the 12. Conclusion Muscle cramps have a high prevalence in patients receiving home parenteral nutrition.