Hunger and the transition from parenteral nutrition in hospitalized adults: A descriptive cohort study

Background: Parenteral nutrition (PN) provides nutrition to patients who cannot use the digestive tract. Some patients experience delayed appetite recovery after PN, but the factors contributing to this remain unclear. This study aimed to investigate whether hospitalized patients receiving PN experience reduced hunger or appetite.

Methods: A descriptive cohort study was conducted on adults who underwent PN between April 2022 and July 2023. Data on patient characteristics and nutritional support were collected from medical records. Hunger and satiety were assessed using a validated tool during three phases: clinical stability with calorie-protein targets on PN, transition to oral/enteral feeding, and PN withdrawal. The primary outcome was the absence of hunger assessed by the tool.

Results: Of 231 screened patients, 102 were included. Among these, 62.7% reported hunger during PN. Lipid doses and energy reduction strategies did not affect hunger or satiety. Transition success to oral/enteral nutrition was 2.38 times higher in patients who experienced hunger compared to those who did not (95% CI: 1.59-3.54). Poisson regression identified higher age, inflammation, and metastatic cancer as independent factors associated with the absence of hunger.

Conclusion: This study suggests that PN does not suppress hunger and that factors other than nutritional therapy (age, inflammation, and cancer) could explain the absence of appetite. Considering individual conditions and needs, these findings could guide decision-making strategies regarding the transition from PN to oral/enteral feeding.