title: [Home parenteral nutrition in infants and children in a tertiary level hospital between 1993 and 2009].
abstract: Home parenteral nutrition (HPN) has a key role in the management of permanent or transient intestinal failure in the pediatric patient. Although its use is not without complications. We review our experience since the beginning of the program in 1993.
  
  
  METHODS
  Longitudinal and retrospective study of the clinical records from 25 infants and children (11 boys, 14 girls) who received HPN in this period. If a patient received HPN in periods separated more than 3 months we consider a different episode. In this way, 32 episodes were described. Quantitative data are presented as mean or median and qualitative as frequency. Complications are presented as complication rate per 1,000 days of HPN.
  
  
  RESULTS
  16 patients started HPN younger than 1 year. Total length of HPN was 9,986 days, median 174 days (range 7 to 2,444 days). Main indication was short bowel syndrome (n = 6); motility disorders (n = 6); chronic diarrhea (n = 5), malnutrition (n = 3) and other causes (n = 5). 47 catheters were used; mean length 212.5 days, median 120 days (range: 7 to 930). Most of central venous catheters were tunnelled catheters (n = 42); subcutaneous ports (n=3) and in two cases periferically inserted central catheters (PICCS). Complication rate per 1,000 days of HPN was: 3.4 for catheter-related infections, 0.1 for obstruction; 0.9 for leakage, and 0.1 for accidental removal. Most common microorganisms were Staphylococcus coagulase negative (47%), Gram negative bacteria (21%), Staphylococcus aureus (15%), fungi (9%) and others in 9%. Parenteral nutrition-associated liver disease was present in 4 patients. 21 patients were weaned off HPN, 3 patients deceased because of underlying disease, 2 patients underwent intestinal transplantation, while 5 patients continue in the program.
  
  
  CONCLUSIONS
  Every year two new patients enter in the program. 65% of patients were weaned off HPN. Infectious complications were the most frequent (rate 3.4 infections per 1,000 days of HPN). Mean length of HPN was 174 days, and 120 days for catheters.
authors.affiliation: Sección de Gastroenterología y Nutrición Infantil y Servicio de Farmacia., Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: A Ma
authors.initials: AM
authors.lastname: Cordero Cruz
authors.forename: Ma J
authors.initials: MJ
authors.lastname: Aguilella Vizcaíno
authors.forename: C
authors.initials: C
authors.lastname: González Fuentes
authors.forename: Ma
authors.initials: M
authors.lastname: Rubio Murillo
authors.forename: J M
authors.initials: JM
authors.lastname: Moreno Villares
authors.forename: P
authors.initials: P
authors.lastname: Gomis Muñoz
authors.forename: A
authors.initials: A
authors.lastname: Herreros de Tejada
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D016331:Parenteral Nutrition, Home / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology