Home parenteral nutrition: clinical and laboratory analysis of initial experience (1994-1997). Implications for patient management.
BACKGROUND/AIM AND METHOD: Severe malabsorption often necessitates prolonged parenteral nutrition. Home parenteral nutrition (HPN) offers the opportunity for treatment at home. We report clinical and laboratory data of initial 27 HPN patients of one center since its opening in 1994.


RESULTS
Clinical and biological markers of nutritional status were normalized and well maintained in most patients. Except for vitamin E and selenium (lower in HPN patients), the other vitamin and micronutrient levels were normal. There was no obvious essential fatty acid deficiency. Cholestasis was usual, but only 1 patient had a severe hepatic disease. Catheter infection occurred 18 times 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. Social rehabilitation and, in some patients, full professional rehabilitation were constant.


CONCLUSIONS
These data confirm that HPN performed in centers with expertise allowed patients to overcome gut failure and to recover subnormal or normal nutritional status. Satisfactory social rehabilitation was obtained in all patients. HPN complications were rarely life-threatening, and their frequency decreased with experience.
Reimund
J
J
Service d'Hépatogastroentérologie et d'Assistance Nutritive, Centre Agréé de Nutrition Parentérale à Domicile, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France. jean-marie.reimund@chru-strasbourg.fr
Duclos
B
B
Cuby
C
C
Malzac
D
D
Zimmermann
F
F
Dietemann
J L
JL
Beretz
L
L
Baumann
R
R
D000368:Aged; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation; D003365:Costs and Cost Analysis; D004734:Energy Metabolism / Q000502:physiology; D005227:Fatty Acids / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D016331:Parenteral Nutrition, Home / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D011788:Quality of Life; D014131:Trace Elements / Q000097:blood; D014815:Vitamins / Q000097:blood; D014882:Water-Electrolyte Balance / Q000502:physiology
D005227:Fatty Acids; D014131:Trace Elements; D014815:Vitamins