Home parenteral nutrition: Clinical and laboratory analysis of initial experience (1994-1997) - Implications for patient management

Background/Aim and Method: Severe malabsorption often necessitates prolonge d parenteral nutrition. Home parenteral nutrition (HPN) offers the opportun ity for treatment at home. We report clinical and laboratory data of initia l 27 HPN patients of one center since its opening in 1994. Results: Clinica l and biological markers of nutritional status were normalized and well mai ntained in most patients. Except for vitamin E and selenium (lower in HPN p atients), the other vitamin and micronutrient levels were normal. There was no obvious essential fatty acid deficiency. Cholestasis was usual, but onl y 1 patient had a severe hepatic disease. Catheter infection occurred 18 ti mes in 13 patients, but the frequency decreased with time (from 4.2 to 1.7 infections/1,000 days on HPN). No patient died from HPN complications. Soci al rehabilitation and, in some patients, full professional rehabilitation w ere constant. Conclusions: These data confirm that HPN performed in centers with expertise allowed patients to overcome gut failure and to recover sub normal or normal nutritional status. Satisfactory social rehabilitation was obtained in all patients. HPN complications were rarely life-threatening, and their frequency decreased with experience. Copyright (C) 2000 S. Karger AG, Basel.