HOME-BASED ENTERAL NUTRITION IN CHILDREN AND ADOLESCENTS - EXPERIENCEIN 79 PATIENTS

A study of home-based enteral nutrition (HBEN) was conducted in 79 chi ldren and adolescents managed at the Lille Teaching Hospital, France, between March 1990 and May 1993. The physicians of the hospital prescr ibed the enteral nutrition regimens; dieticians, also from the hospita l, monitored the patients; and a private company supplied and maintain ed the equipment used in the patients' homes. The cost of HBEN was rei mbursed by the French national social security system. Family members of infants and adolescents played a significant role in initiating ent eral nutrition and in preventing complications. The disorders requirin g HBEN were intestinal in some patients (malabsorption) and extraintes tinal in others (e.g., neuromuscular diseases). Nutrients were deliver ed via a nasogastric tube (n = 64), a gastrostomy tube (n = 14), or a jejunostomy tube (n = 1). Mean duration of HBEN (+/- 1 SD) was 8 +/- 6 months, and mean weight gain was 5 +/- 4 kg. The weight over height r atio, which was estimated in 44 patients, increased significantly, fro m 86% +/- 6% at initiation of HBEN to 106 +/- 15% at completion of HBE N (p < 0,01). HBEN provided 89% +/- 19% of the recommended energy inta ke. There were few complications during the study period. Of the six p atients with vomiting, four had a gastroesophageal reflux. Two patient s discontinued the treatment for psychological reasons. There were two deaths, which were unrelated to HBEN. HBEN was effective in improving the nutritional status of the children and adolescents included in th e study. The HBEN program proved both flexible reliable.