Introduction: Mucositis is a major complication in intensive chemotherapy, which often necessitates total parenteral nutrition (TPN). While the side effects of the conditioning regimes vary with regard to degree of severity among individual’s and between transplant types, the gastrointestinal (GI) toxicities have an immense impact on the short-term nutritional status of the transplant patients. Additionally, patients who have undergone allogeneic transplant (related or unrelated) are uniquely susceptible to graft versus host disease (GvHD), which has both short and long-term nutritional consequences. TPN imply an increased risk for infections. There is a lack of knowledge concerning the effect of oral cryotherapy on nutrition for patients treated with superintensive chemotherapy before bone marrow transplantation.
Objective: The objective with the present study was to evaluate if oral cryotherapy during chemotherapy may reduce number of days with TPN due to less intensity of oral pain from mucositis. Material and metod: All patients 18 years and older, who were scheduled for bone marrow transplantation were included consecutively and randomised to oral cryotherapy or routine oral care. A stratified randomisation was used with regard to type of transplantation. The number of days of total parenteral nutrition was collected from the patient’s medical and nursing record.
Result: The result showed that fewer patients in the experimental group (41%) than in the control group (51%) received TPN (n = 16 vs 20). There was a tendency to fewer days with TPN in the experimental group (4.2 ± 3.9) compared to the control group (6.6 ± 4.8) among patients with autologous transplantation even though it did not reach a significant level. The kreatinin level was significantly lower in the experimental group at day 3-5, 9 and 9-21.
Conclusion: Oral cryotherapy indicates that fewer patients are in the need of total parenteral nutrition (TPN) and that the number of days with TPN is reduced for patients treated with superintensive chemotherapy before autologous bone marrow transplantation.