Abstract:The low incidence of home artificial nutrition over all the patients assisted by the ANT Foundation and the achievement to avoid death from cachexia in 78% prove the efficacy of the criteria of patient selection in order to prevent its excessive and indiscriminate use. It was effective in maintaining and improving the performance status in 88% of patients. Karnofsky performance status is a reliable prognostic index to start home artificial nutrition.
“…Parenteral nutrition may improve weight and maintain or improve performance status in selected patients, but it is not routinely recommended. Careful evaluation should be employed to identify those patients who would benefit and to avoid indiscriminate use of artificial nutrition , especially in cases of futile care and at end of life. Benefits may be limited to the perioperative setting for patients who are unable to tolerate oral nutrition, although there is a need for more explicit criteria for use .Parenteral nutrition may improve weight and maintain or improve performance status in selected patients, but it is not routinely recommended.…”
This review highlights the etiology, assessment, and management of unintentional weight loss in patients with pancreatic cancer and provides recommendations for best supportive care.
“…Parenteral nutrition may improve weight and maintain or improve performance status in selected patients, but it is not routinely recommended. Careful evaluation should be employed to identify those patients who would benefit and to avoid indiscriminate use of artificial nutrition , especially in cases of futile care and at end of life. Benefits may be limited to the perioperative setting for patients who are unable to tolerate oral nutrition, although there is a need for more explicit criteria for use .Parenteral nutrition may improve weight and maintain or improve performance status in selected patients, but it is not routinely recommended.…”
This review highlights the etiology, assessment, and management of unintentional weight loss in patients with pancreatic cancer and provides recommendations for best supportive care.
“…Some data exist in patients followed at home. In large studies of advanced cancer patients followed at home, the PN rate was even lower, about 1.1% (6,7). In another survey performed in home care patients, 11% of patients were receiving PN.…”
Section: Discussionmentioning
confidence: 94%
“…The mean age was 58 yr (range 37-79), and 9 were males. The mean hospital stay was 7.7 days (range [3][4][5][6][7][8][9][10][11][12][13][14], and the mean Karnofsky level was 35 (range 10-50). The principal indication was bowel obstruction.…”
The aim of this study was to estimate the use of parenteral nutrition (PN) in advanced cancer patients enrolled in an acute pain relief and palliative care unit of a comprehensive cancer center and the appropriateness of the criteria to select patients for PN. Fourteen out of 750 patients (1.8%) admitted to an acute palliative care unit were administered PN. Patients were referred from various settings. The mean age was 58 yr (range 37-79), and 9 were males. The mean hospital stay was 7.7 days (range 3-14), and the mean Karnofsky level was 35 (range 10-50). The principal indication was bowel obstruction. Ten patients (71%) were already receiving PN before admission, and 2 of them discontinued the treatment during admission. Four patients (29%) started PN during hospital admission as decided by the staff. Twelve patients (85%) were discharged on PN. One week after hospital discharge, 9 patients were still receiving PN, 4 patients died, and no data were available for 1 patient. One month after hospital discharge only 2 patients of these were still on PN, 2 patients discontinued PN, and 5 patients died. This study shows that decisions to start or to stop PN were individually based on multiple considerations, not only clinical. Goals may vary from expected clinical benefits to compassionate use. The administration of PN should be assessed carefully and individually approached.
“…In addition, the researchers used certain psychometric measurements and/or parameters such as weight followâup, Body Mass Index (BMI) and serum albumin level. The Karnofsky Performance Status (KPS) scale, which was developed to evaluated the performance status of patients, has been the most used measurement tool, which has in total been used in eight different pieces of research (Bozzetti et al, ; Chermesh et al, ; Cotogni et al, ; Culine et al, ; Pasanisi et al, ; Ruggeri et al, ; Vashi et al, ; Violante et al, ). In five of the studies, with the aim of evaluating the quality of life of the patients, Functional Assessment of Cancer TherapyâGeneral (FACTâG), the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTCâQLQâC30), the qualityâofâlife questionnaire was related to nutritional status (QLQrNS) and Rotterdam symptoms checklist (RSCL) measurement tools were used (Bozzetti et al, ; Culine et al, ; GomezâCandela et al, ; Senesse et al, ; Vashi et al, ).…”
Purpose
Total Parenteral Nutrition began to be applied frequently in the houses of patients starting from the 1990s and is stated in literature as Home Parenteral Nutrition (HPN). The purpose of this review is to answer the question of whether or not HPN is safe for cancer patients.
Methods
Searches were conducted in Cochrane, CINAHL, PubMed, Springer, Google Scholar, and the Web of Science databases.
Results
The 1,949 articles were accessed in the total, and 20 articles have been included in the review. In the studies being evaluated, it can be determined that HPN has influenced the quality of life, performance status, and the nutrition level of cancer patients positively. Most frequently seen complications were infections relating to the catheter, the mechanical obstruction in the catheter and venous thrombosis. For each 1,000Â days with HPN or a catheter, infections in the interval of 0.05 and 3.08, mechanical problems in the interval of 0.07 and 2.13, and thrombosis in the interval of 0.05 and 0.20 were determined.
Conclusions
While HPN influenced quality of life, nutrition, and the personal performance of cancer patients positively, the rate of complications is at a level that can be managed at home.
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