Ambulatory Home Total Parenteral Nutrition

Abstract

Ambulatory total parenteral nutrition (TPN) at home was used in 85 patients within a 6-yr period Indications include severe malabsorption, fistulas, anorexia nervosa, and malignancies. The median duration of home TPN (HPN) was 67 days (range: 30–4,155 days). HPN duration for patients with benign diseases was longer [357.12 days (range: 30–4,155 days)] than for cancer patients [93.54 days (range: 30–421 days)]. Under HPN, patients gained a good nutritional status with an increase of total protein (p > 0.001) and serum albumin levels (p > 0.001). Weight gain was also significant (p > 0.001). The rehospitalization rate was low (7.8%), but it was higher when HPN lasted for more than 3 months (10.87% ± 1.58%) compared with short-term HPN (5.69% ± 1.25%). Metabolic complications were unusual, and rehospitalization was related to the oncological treatment and/or infectious complications. Therefore, ambulatory HPN is a nutritional support that can significantly improve the life of patients with alimentary failure. Moreover, HPN allows significant cost savings compared to the alternative of prolonged hospitalization. (Journal of Parenteral and Enteral Nutrition 11:475–479,1987)