Home parenteral nutrition after near total enterectomy.
Six patients with extreme short bowel syndrome (4.2 +/- 4.9 cm of residual small bowel) were provided home parenteral nutrition (HPN) for 14,397 days. The average age at onset of HPN was 38 years (18-64 years). Patients maintained body weight at 97% of ideal (86-112%) with mean serum albumin of 3.7 +/- 0.6 g/dL (normal 3.5-5.8 g/dL), serum transferrin of 341 +/- 104 mg/dL (normal 200-400 mg/dL), and mean serum pre-albumin of 27.5 +/- 12.6 mg/dL (normal 16.6-43 mg/dL). Hospital admission for HPN-related complications was required 10.3 times/patient for a total of 864 hospital days and was catheter related in 71% of episodes. Catheter sepsis occurred once per 436 catheter days and required catheter removal in only 33% of instances. Five patients were able to resume an oral diet, five had returned to work or school, and three were married with family. HPN allowed return to a quality productive life with acceptable morbidity following catastrophic massive bowel resection.
Nance
M L
ML
Division of Gastrointestinal Surgery and PENN Infusion Therapy, University of Pennsylvania School of Medicine, Philadelphia.
Morris
J B
JB
Mullen
J L
JL
D000293:Adolescent; D000328:Adult; D002404:Catheterization / Q000009:adverse effects; D006801:Humans; D007239:Infections / Q000209:etiology; D007422:Intestines / Q000601:surgery*; D008875:Middle Aged; D016331:Parenteral Nutrition, Home / Q000009:adverse effects; D012778:Short Bowel Syndrome / Q000628:therapy*