Experience of 6 years with home enteral nutrition in an area of Spain

Abstract

Objective: The wide spread use of long-term enteral nutrition and the substantive costs dictate a need to study outcome, clinical and epidemiological characteristics of these patients. The aim of our study was to analyze incidence and characteristics of a cohort of patients on HEN during 6 years, after our previous pilot study of 3 years. Design: Prospective observational study. Setting: Tertiary care. Subjects: Between January 1999 and December 2004, all adult patients living in Valladolid West area who were discharged from the hospital on HEN were prospectively studied and followed up. Interventions: Information for each patient was prospectively recorded by the dietitian of the team, and include age, sex, body mass index, tricipital skinfold, midarm circumference, underlying disease, exitus, dates of initiation and discontinuation of HEN, nutrient formula, mode of administration and complications of HEN. During HEN, physicians supervised the home patients and the patients themselves or their close relative, were asked to contact our nutrition team if any problem occurred. Finally the yearly incidence of HEN was calculated each year on the basis of the estimated population in our area of recruitment, assuming almost all HEN patients were reported.

Complications of Home Enteral Nutrition: Mechanical Complications and Access Issues in the Home Setting

“…NETs generally provide nutrition support for 4–6 weeks, but the increased potential for significant complications arises with longer‐term use of nasoenteric feeding access 15 . The most common long‐term morbidities include sinusitis, erosion of the nasal cartilage, esophageal stricture, and disruption of the integrity of the upper and lower esophageal sphincter, leading to gastroesophageal reflux, aspiration, and pneumonia 1 …”

“…Enteral tube feeding often becomes the primary method of nutrient delivery for the critically ill, those with poor voluntary intake, and individuals with abnormal gut function or dysphagia (neurologic or mechanical). Although there remains regional variation with regard to home enteral nutrition (HEN) practices, neurologic diseases and malignancies constitute common indications necessitating enteral access and HEN 1 . Neurologic diseases may result in dysphagia, aspiration, or a lack of swallowing coordination.…”

Nutrición enteral domiciliaria en la Región de Murcia. Perfil de la muestra, evolución del coste y perspectiva. Años 2007-2010

“…comunicaron en 2013 los resultados de un estudio prospectivo de seguimiento de pacientes con NED en Valladolid durante 12 años (1999-2010). La patología de base más frecuente fue la oncológica (43,8%), seguida de la infección por VIH (26,8%) y de las causas neuroló-gicas (9,6%) (17,18).…”

“…En el estudio gallego (16) la vía de administración de la NED más utilizada fue la oral (58,3%), seguida de sonda nasogástrica (28,46%), la PEG (9,87%), gastrostomía (6,5%) y yeyunostomía (0,65%). Por último, en el trabajo en Valladolid (1999-2010), la vía de administración predominante fue la oral, que representa el 68,28%, la SNG un 24,3%, la gastrostomía un 6,8% y la yeyunostomía 0,6%; siendo los cambios a lo largo del tiempo escasos (17,18). Si bien la distribución difiere entre los diferentes registros y estudios, suele prevalecer un orden similar.…”

Implementación de una vía clínica de prescripción de nutrición enteral domiciliaria de Murcia. Perfiles y características muestrales

“…Las principales características de esta muestra discrepaban con los datos de la mayoría de los registros de NED publicados, tanto de grupos nacionales (7)(8)(9)(10)(11)(12)(13)(14) como internacionales (15)(16)(17).…”