Saturday, January 30, 2010
Avoid TPN in patients with ventricular assist devices
There's a new paper in Clinical Infectious Diseases on fungal ventricular assist device (VAD) infections. If you have ever seen these infections, you will appreciate the need for a better understanding of the risk factors for them. This paper reviewed 300 patients with VADs, of whom 108 developed infections, 23 of these due to Candida spp. Crude mortality in patients with Candida infection was 91%. Using mulitvariate analysis to compare patients with fungal VAD infections to those with bacterial VAD infections, the only independent predictor for fungal infection was total parenteral nutrition (OR 6.95). The authors of the paper strongly recommend that TPN be avoided in VAD patients.