Home parenteral nutrition: An international benchmarking exercise

Baxter, J.; Gillanders, Lyn; Angstmann, K.; Staun, Michael; O’Hanlon, Carmel; Smith, Trevor; Joly, F.; Thul, P.; Jonkers, C.; Wanten, Geert; Gardiner, Keith; Kłęk, Stanisław; Cuerda, C.; Magambo, W.; Hawthorne, A. B.; Lukes, Andrea S.; Gossum, A. Van; Theilla, Miriam; Singer, Pierre; Shamir, Raanan; Pironi, Loris

doi:10.1016/j.clnme.2012.08.001

Cited by 16 publications

(24 citation statements)

References 4 publications

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“…21,30 Thus, even in Denmark, where the highest global HPN incidence and prevalence have been reported, 21 this trend has exponentially continued, and a plateau was evidently not even reached by the end of 2009. 6 This may reflect that healthcare professionals in Denmark have become aware that HPN is no longer an experimental option but, in fact, a legal obligation, where patients of any age, diagnosis, or bowel anatomy must be referred to a dedicated IF center should the intestine fail. As indicated in the recordings of the bowel anatomy, most patients were referred with a high ostomy for HPN, and 12% of the patients with IF could subsequently be weaned off HPN following surgical restoration of bowel anatomy.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] The evolution and clinical use of HPN have varied among countries. 6 In Denmark, this evolution was initially pioneered by Jarnum 7 and Ladefoged, 8 and presumably due to the small size of the country, a government-financed, public healthcare system with free access for all citizens to hospitals and 655449P ENXXX10.1177/0148607116655449Journal of Parenteral and Enteral NutritionBrandt et al research-article2016 essential treatment, a tradition for centralization of the care for patients with other organ failures, and centers of experience and even excellence have emerged. The first and largest of these centers was established at Rigshospitalet, where the first Danish patient with IF was discharged with HPN on August 26, 1970.…”

Section: Introductionmentioning

confidence: 99%

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Home Parenteral Nutrition in Adult Patients With Chronic Intestinal Failure: The Evolution Over 4 Decades in a Tertiary Referral Center

Brandt

Hvistendahl

Naimi

et al. 2016

J Parenter Enteral Nutr

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Home Parenteral Nutrition in Adult Patients With Chronic Intestinal Failure: The Evolution Over 4 Decades in a Tertiary Referral Center

Brandt

Hvistendahl

Naimi

et al. 2016

J Parenter Enteral Nutr

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“…Home parenteral nutrition (HPN) allows the delivery of nutrition intravenously in the home setting. Few hospitals in Australia offer this service and, overall, Australia has small numbers of HPN patients in comparison to European countries . The AuSPEN HPN Register indicates that there are currently 109 patients receiving HPN in Australia…”

Section: Introductionmentioning

confidence: 99%

“…Also unique to Australia is the geographic challenge of providing an equitable service to all patients across vast distances. This has meant that Australia has a greater number of HPN centres, each with fewer patients compared with the European model …”

Section: Introductionmentioning

confidence: 99%

Impact of home parenteral nutrition on daily life: A qualitative study of eight patients

Tsang

Carey

2013

Nutrition & Dietetics

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Aim: Existing qualitative research reveals that people on home parenteral nutrition often experience psychological problems, such as anxiety and depression, and social impairment. The aim of the present study was to explore the impact of home parenteral nutrition on daily living in a cohort of Australian patients. Methods: All eight patients receiving home parenteral nutrition at a large tertiary hospital were recruited for a semistructured interview face-to-face or by phone. Questions for interview included impact of home parenteral nutrition on general life, eating habits, social life and quality of living. An inductive thematic analysis approach was used. Results: Analysis showed that participants feel that home parenteral nutrition has many restrictions due to stringent regimens and limitations in being able to participate in activities such as swimming and travelling. Despite these restrictions, patients felt home parenteral nutrition had improved their quality of living, and it was seen as a life-saving intervention. Eating habits were changed due to medical conditions rather than due to home parenteral nutrition. Social life of participants was not greatly affected. Conclusion: Patients reported that their daily living was improved by home parenteral nutrition despite the associated burdens. Health professionals should consider earlier initiation of home parenteral nutrition in intestinal failure patients to improve quality of living for these patients. A more structured multidisciplinary model of care would ensure that patients have access to psychological support where required.

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“…Other countries in Europe have reported HPN prevalence of 0.65–12.7 for adults and 0.34–8.92 in pediatric populations . The period prevalence of HPN across 16 European countries has also been reported as an extremely wide range (3.25–66 patients per million) …”

Section: Prevalence Of Home Parenteral Nutritionmentioning

confidence: 98%

Use of Lipids in Adult Patients Requiring Parenteral Nutrition in the Home Setting

Mundi

Kłęk²,

Martindale

2020

J Parenter Enteral Nutr

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It is estimated that over 25,000 Americans receive home parenteral nutrition (HPN), mostly because of intestinal failure (IF). Although there is significant variability in the fluid and energy needs of patients receiving HPN, intravenous lipid emulsions (ILEs) are an essential part of the macronutrient composition, serving as an excellent source of non‐protein energy, as well as supplying essential fatty acids. However, the long‐term use of ILEs in particular may be associated with some detrimental health effects, such as intestinal failure associated liver disease (IFALD). Although there is lack of unifying diagnosis, IFALD can present as cholestasis, steatosis, or fibrosis, with a prevalence that ranges between 5% and 43%. The development of IFALD tends to be multifactorial. Risk factors of IFALD can include those related to IF, inflammation/infection, and long‐term parenteral nutrition. Some studies have shown a link between development of IFALD and ILE dose, especially if the dose is >1 g/kg/d, with high ω‐6:ω‐3 polyunsaturated fatty acid (PUFA) ratio and phytosterol content being theorized as some contributing factors. Thus, efforts have been made to use alternative oils (olive oil, medium‐chain triglycerides, and fish oil) to reduce the soybean‐oil content of ILE, which tends to be high in ω‐6 PUFA and phytosterols. Although additional long‐term clinical data are emerging, this strategy, as reviewed in the current manuscript, has shown to provide some benefit in both prevention and treatment of IFALD and other sequelae of HPN.

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Home parenteral nutrition: An international benchmarking exercise

Cited by 16 publications

References 4 publications

Home Parenteral Nutrition in Adult Patients With Chronic Intestinal Failure: The Evolution Over 4 Decades in a Tertiary Referral Center

Home Parenteral Nutrition in Adult Patients With Chronic Intestinal Failure: The Evolution Over 4 Decades in a Tertiary Referral Center

Impact of home parenteral nutrition on daily life: A qualitative study of eight patients

Use of Lipids in Adult Patients Requiring Parenteral Nutrition in the Home Setting

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