title: Outcome of home parenteral nutrition in 251 children over a 14-y period: report of a single center.
abstract: Parenteral nutrition (PN) is the main treatment for intestinal failure.
  
  
  
  We aimed to review the indications for home parenteral nutrition (HPN) in children and describe the outcome over a 14-y period from a single center.
  
  
  
  We conducted a retrospective study that included all children who were referred to our institution and discharged while receiving HPN between 1 January 2000 and 31 December 2013. The indications for HPN were divided into primary digestive diseases (PDDs) and primary nondigestive diseases (PNDDs). We compared our results to a previous study that was performed in our unit from 1980 to 2000 and included 302 patients.
  
  
  
  A total of 251 patients were included: 217 (86%) had a PDD. The mean ± SD age at HPN onset was 0.7 ± 0.3 y, with a mean duration of 1.9 ± 0.4 y. The indications for HPN were short bowel syndrome (SBS) (59%), PNDD (14%), congenital enteropathies (10%), chronic intestinal pseudo-obstruction syndromes (9%), inflammatory bowel diseases (5%), and other digestive diseases (3%). By 31 December 2013, 52% of children were weaned off of HPN, 9% of the PDD subgroup had intestinal transplantation, and 10% died mostly because of immune deficiency. The major complications of HPN were catheter-related bloodstream infections (CRBSIs) (1.7/1000 d of PN) and intestinal failure-associated liver disease (IFALD) (51 children; 20% of cohort). An increased rate of CRBSIs was observed compared with our previous study, but we saw a decreasing trend since 2012. No noteworthy deceleration of growth was observed in SBS children 6 mo after weaning off HPN.
  
  
  
  SBS was the major indication for HPN in our cohort. IFALD and CRBSIs were potentially life-threatening problems. Nevertheless, complication rates were low, and deaths resulted mostly from the underlying disease.
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon abn.doc@gmail.com.
authors.forename: Elie
authors.identifier: 0000-0002-8422-1200
authors.initials: E
authors.lastname: Abi Nader
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition.
authors.forename: Cécile
authors.initials: C
authors.lastname: Lambe
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition.
authors.forename: Cécile
authors.initials: C
authors.lastname: Talbotec
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition.
authors.forename: Bénédicte
authors.identifier: 0000-0002-5324-9964
authors.initials: B
authors.lastname: Pigneur
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition.
authors.forename: Florence
authors.initials: F
authors.lastname: Lacaille
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition.
authors.forename: Hélène
authors.identifier: 0000-0002-8575-9627
authors.initials: H
authors.lastname: Garnier-Lengliné
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition.
authors.forename: Laetitia-Marie
authors.initials: LM
authors.lastname: Petit
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition.
authors.forename: Catherine
authors.initials: C
authors.lastname: Poisson
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition.
authors.forename: Amélia
authors.initials: A
authors.lastname: Rocha
authors.affiliation: Pharmacy, and Paris Descartes University, Paris, France; and.
authors.forename: Odile
authors.initials: O
authors.lastname: Corriol
authors.affiliation: Pediatric Surgery and Transplantation, Necker Enfants Malades University Hospital, Certified Center for Home Parenteral Nutrition, National Reference Center for Rare Digestive Diseases in Children, APHP, Paris, France; Paris Descartes University, Paris, France; and.
authors.forename: Yves
authors.initials: Y
authors.lastname: Aigrain
authors.affiliation: Pediatric Surgery and Transplantation, Necker Enfants Malades University Hospital, Certified Center for Home Parenteral Nutrition, National Reference Center for Rare Digestive Diseases in Children, APHP, Paris, France; Paris Descartes University, Paris, France; and.
authors.forename: Christophe
authors.identifier: 0000-0002-3248-5650
authors.initials: C
authors.lastname: Chardot
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition, Paris Descartes University, Paris, France; and.
authors.forename: Frank M
authors.initials: FM
authors.lastname: Ruemmele
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition.
authors.forename: Virginie
authors.initials: V
authors.lastname: Colomb-Jung
authors.affiliation: Departments of Pediatric Gastroenterology, Hepatology and Nutrition, Paris Descartes University, Paris, France; and.
authors.forename: Olivier
authors.identifier: 0000-0002-9222-9421
authors.initials: O
authors.lastname: Goulet
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000628:therapy; D008107:Liver Diseases / Q000453:epidemiology; D008297:Male; D016331:Parenteral Nutrition, Home / Q000009:adverse effects; D011379:Prognosis; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000628:therapy; D016896:Treatment Outcome
keywords: children; complications; growth; home parenteral nutrition; outcome