Abstract
BACKGROUND: Parenteral nutrition (PN) is required by people with intestinal failure and can be delivered as multi-chambered bags (MCBs) or individually compounded (COM) bags. This systematic review aimed to examine the evidence base for clinical outcomes and/or quality of life (QoL) in adults receiving PN as MCBs compared to COMs in hospital and community settings. METHODS: A systematic database search was conducted between January 2015 and May 2024. Studies assessing adults in receipt of MCBs were included. Quality was assessed using Joanna Briggs appraisal tools. A narrative synthesis was performed due to study heterogeneity. PROSPERO: CRD42022352806. RESULTS: Ten studies including 87,727 adults were included, with 20,192 receiving PN from MCBs and 67,535 from COMs. Eight studies reported on PN given in hospital and two in the home. Five hospital-based and one home-based study reported that MCBs were well tolerated and provided adequate nutrition. Three hospital-based studies reported that MCBs had lower post-operative infections and a lower mean risk of catheter-related bloodstream infections (CRBSIs). Two home-based studies reported no difference in CRBSI. Five hospital-based studies reported no difference between groups in length of hospital stay. Three hospital-based studies reported the cost to be lower for MCBs than COMs, and no studies reported QoL. CONCLUSIONS: The studies included show that MCBs provided in hospital are safe and non-inferior to COMs and may be more cost-effective. There were few high-quality studies and no data on QoL; therefore, further work is required to improve the certainty of the evidence and to establish the level of QoL when using MCBs.