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Professor, Department of Pharmacy Practice, College of Pharmacy, Southwestern Oklahoma State University, Weatherford, OK
Published Online, July 17, 2007. www.theannals.com, DOI 10.1345/aph.1K190
Format: This paperback book contains 16 chapters, 4 appendices, numerous boxes, figures, color plates, and tables, in addition to an index.
Audience: The intended primary audience is mid- to upper-level healthcare providers in the UK who either are or will be involved with the screening, ordering, and monitoring of parenteral nutrition in adult patients. This book would be an excellent reference for clinical dieticians, pharmacists, and physicians in the UK who need to enhance their parenteral nutrition knowledge.
Purpose: The purpose of this book is to impart the knowledge necessary to administer parenteral nutrition safely and appropriately, in a cost-effective manner, to adults.
Content: Introductory chapters review the importance of nutrition and oral/enteral support options. Approximately 25% of the book is dedicated to the decision-making and patient-evaluation processes undertaken to determine whether parenteral nutrition is appropriate. Three chapters are devoted to base solution formulation issues, electrolyte balance, and the provision of micronutrients. Disease-specific considerations, regimen selection, complications, and monitoring recommendations of parenteral nutrition account for 25% of the chapters. Individual chapters discuss the organization and function of a nutritional support service and the need for good communication between prescribers and technical services (compounding facility). The final chapter details strategies for initiating, delivering, and discontinuing parenteral nutrition safely. The 4 appendices cover stability, calculations, micronutrient provision, and products available in the UK, as well as oral/enteral solutions for patients with short-bowel syndrome.
Usability: This book is well written and properly referenced and excels at supplementing general concepts presented in each chapter with specific details in accompanying tables and figures. The book is arranged logically and provides a comprehensive, stepwise approach to the provision of parenteral nutrition and pertinent related topics (eg, enteral nutrition). However, it is not designed to be a how-to manual or quick reference source; to gain maximal benefit from this book, it should be read in its entirety.
Highlights: Prescribing Adult Intravenous Nutrition provides a very thorough review of the information needed to determine whether parenteral nutrition is appropriate for a particular patient. Although not the focus of this book, the review of enteral feeding considerations based on gastrointestinal abnormalities and feeding tube placement was very informative.
Limitations: Adding a comprehensive case-based example that illustrates the appropriate provision of nutritional support, from pretherapy screening to posttherapy follow-up, would have enhanced the concepts presented. This book is written specifically for practitioners in the UK and has many specific references to the UK National Institute for Health and Clinical Excellence and the British Association for Parenteral and Enteral Nutrition guidelines. Numerous differences in terminology, prescribing units (mmol vs mEq), laboratory units, general prescribing philosophies, and solution compounding processes (centralized technical services vs onsite customized compounding abilities) make this book in-appropriate for new practitioners attempting to develop skills in the US. Seasoned nutritional support practitioners in the US will easily be able to identify and overlook the differences but will benefit little, since most of the data presented should already be part of their working knowledge.
Comparison with Other Related Books: Practitioners in the US would be better served by reviewing the nutrition support guidelines and using the Nutrition Support Practice Manual or Science & Practice of Nutrition Support: Case-Based Core Curriculum, both available through the American Society for Parenteral and Enteral Nutrition.
Reviewer's Summary: This informative, reasonably priced book is well written and would be an excellent resource for practitioners interested in nutritional support in the UK. Unfortunately, too much of the data presented in the book are specific to processes, guidelines, and pharmaceutical products unique to the UK, thus limiting the benefit of this book for practitioners in the US.
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