Adult Home Parenteral Nutrition: a clinical evaluation after a 3-year experience in a Southern European centre

Violante, G.; Alfonsi, L.; Santarpia, Lidia; Cillis, M C; Negro, G.; Caprio, Carmela De; Russo, Nicole; Contaldo, Franco; Pasanisi, Fabrizio

doi:10.1038/sj.ejcn.1602267

Cited by 32 publications

(19 citation statements)

References 17 publications

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“…HPN is a lifesaving therapy in many oncological and nononcological patients [52][53][54][55] when oral nutrition is impossible or severely impaired. Being a long-term therapy, it requires specialized nutritional teams in order to optimise routine clinical care and to reduce possible complications [19,54].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of long-term home parenteral nutrition in non-oncological patients: a report from two specialised centres

et al. 2007

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Section: Discussionmentioning

confidence: 99%

Clinical outcome of long-term home parenteral nutrition in non-oncological patients: a report from two specialised centres

et al. 2007

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“…SBS is the main clinical indication for home parenteral nutrition [18,19] . Nutrient absorption studies (such as H 2 breath test, D -xylose test, fecal chymotrypsin and fecal lipid dosage) are the gold standard procedures to evaluate gut absorptive function, but are inconvenient and expensive, requiring a metabolic ward.…”

Section: Discussionmentioning

confidence: 99%

Citrulline Blood Levels as Indicators of Residual Intestinal Absorption in Patients with Short Bowel Syndrome

et al. 2008

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Plasma citrulline is known to be a marker of absorptive enterocyte mass in humans. We evaluated whether citrulline and other blood amino acids are indicators of residual small intestinal length and therefore potential predictors of dependence on parenteral nutrition in the long term. We studied 25 patients with short bowel syndrome (SBS) after at least 18 months since last digestive circuit modification; 24 of them were again evaluated 1 year later. Ten patients were weaned off parenteral nutrition and 15 were dependent on parenteral nutrition. Fifty-four healthy volunteers (28 women and 26 men) served as controls. Amino acid levels were determined on serum with high-performance liquid chromatography (HPLC) as well as on blood and serum with tandem mass spectrometry analysis. Five amino acids (citrulline, leucine, isoleucine, valine and tyrosine) were significantly lower in all SBS patients than in controls, whereas glutamine, measured only by HPLC, was significantly higher. Nevertheless, only serum citrulline measured with HPLC was significantly related to small bowel length. We conclude that HPLC remains the reference methodology to evaluate blood or serum amino acid levels in adult population with SBS.

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“…In our study, infectious complications were serious in 6.6% out of the 30 patients. In a large study on HPN involving 447 patients (25), complications occurred in about 25% of the patients, half of which were infectious, but lower infection rates have been reported in other studies (26). Prerequisites for the safe management of HPN require appropriate training of the nursing team.…”

Section: Discussionmentioning

confidence: 94%

Enteral and parenteral nutrition in the later stages of ALS: An observational study

Verschueren

Monnier

Attarian

et al. 2009

Amyotrophic Lateral Sclerosis

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Current practice guidelines state that enteral feeding should be proposed and provided whenever ALS patients show significant dysphagia and/or weight loss. Percutaneous endoscopic gastrostomy (PEG) is usually available at ALS centres, but this method is not indicated in the case of patients with severe respiratory impairment. We undertook a study to assess the feasibility of applying home parenteral nutrition (PN) to ALS patients with respiratory insufficiency, to assess the complications and survival times after the procedure. PN was provided, via an implanted port, to 30 ALS patients with respiratory insufficiency requiring nutritional support. Nutritional and neurological follow-up were carried out. The results were compared with those obtained on a group of 35 patients who underwent PEG, who were subdivided into patients with respiratory insufficiency and those without respiratory insufficiency at the time of the PEG. Post-procedure survival of PEG patients with respiratory insufficiency was similar to those of the PN group. The results of the study suggest that PN is a safe and effective method, which improves the patients' nutritional status and stabilizes their weight in most cases. Home PN could be applied to patients with advanced ALS and poor respiratory function as an alternative to enteral feeding.

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Adult Home Parenteral Nutrition: a clinical evaluation after a 3-year experience in a Southern European centre

Cited by 32 publications

References 17 publications

Clinical outcome of long-term home parenteral nutrition in non-oncological patients: a report from two specialised centres

Clinical outcome of long-term home parenteral nutrition in non-oncological patients: a report from two specialised centres

Citrulline Blood Levels as Indicators of Residual Intestinal Absorption in Patients with Short Bowel Syndrome

Enteral and parenteral nutrition in the later stages of ALS: An observational study

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