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Parenteral nutrition complications in palliative medicine
  1. Zoe Smith1 and
  2. Emily Sills2
  1. 1 Woking & Sam Beare Hospices Limited, Woking, UK
  2. 2 Princess Alice Hospice, Esher, Surrey, UK
  1. Correspondence to Dr Zoe Smith, Woking & Sam Beare Hospices Limited, Woking GU21 3LG, UK; zoe.smith3{at}


Parenteral nutrition in palliative care is contentious, and decisions on starting or continuing its treatment in palliative patients centre on an individual’s preference, balanced with quality of life. This case report describes the unusual onset of pain and agitation secondary to fluid retention, in a patient with metastatic pseudomyxoma peritonei, established on 2.5 L/day of parenteral nutrition. Immediate volume reduction of the parenteral nutrition to 1 L/day successfully reversed the patient’s symptoms. To our knowledge, this is the first case of parenteral nutrition inducing pain and agitation in a palliative care patient. There is no specific internationally acclaimed guidance concerning parenteral nutrition content and volume in palliative patients, due to a lack of high quality studies. This case study highlights the need for further research into parenteral nutrition content and volume in palliative care, to prevent harmful effects from fluid retention, impacting on quality of life.

  • end of life care
  • other cancer
  • pain
  • drug administration
  • lymphoedema
  • delirium

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  • Contributors Background research and article written by ZS. Editorial input from ES.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.