Is home parenteral nutrition safe for cancer patients? Positive effects and potential catheter‐related complications: A systematic review

Abstract

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 1,000 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.

Cost-Effectiveness Analyses of Home Parenteral Nutrition for Incurable Gastrointestinal Cancer Patients

“…We did not reckon on the cost of training for sHPN because free seminars and training were held regularly in Chinese hospitals for patients by doctors, nurses, and pharmacists. However, common complications of sHPN mainly include infections, catheter obstructions, and thrombosis, which raise the significance of catheter care training for patients and homecare nurses ( 12 , 25 ). Therefore, when sHPN is widely accepted and applied in China, full-time personnel should be set up to take charge of training and be paid a corresponding fee.…”

“…Currently, the European Society for Parenteral and Enteral Nutrition (ESPEN) recommends that home parenteral nutrition (HPN) be administered to adult cancer patients who are unable to achieve nutritional requirements through oral food intake or enteral nutrition (EN) and are at risk of malnutrition death ( 7 , 8 ). Patients with incurable gastrointestinal tumors may struggle to meet nutritional needs, whereas the use of supplemental HPN (sHPN) for heterogeneous cancer patients may result in a significant improvement in their quality of life, particularly in terms of physical and functional well-being, and even prolonged survival with manageable complications ( 5 , 9 – 12 ). Studies also showed that appropriate nutrition support was related to better antitumor therapy tolerance and a reduction of therapy toxicity ( 13 ).…”

A Rare Case of Primary Midgut Volvulus Necessitating Extensive Bowel Resection in an Adult

“…It has been shown that short-bowel syndrome can lead to many chronic complications including esophagitis [12], diarrhea [13], hepatic steatosis and cholestasis [14], cholelithiasis, electrolyte and micronutrient deficiencies [15], metabolic bone disease [16], nephrolithiasis [17], d-lactic acidosis [18], and catheter-related complications [19].…”

Early intravenous administration of nutritional support (IVANS) in metastatic gastric cancer patients at nutritional risk, undergoing first-line chemotherapy: study protocol of a pragmatic, randomized, multicenter, clinical trial

“…Available data, however, shows that HPN can be safely provided by caregivers and cancer patients. 38,39 Dissemination Results of the study will be presented at local, national, and international medical meetings. The findings of the study will be published in peer-reviewed medical/scientific journals and made open access on acceptance.…”

“…Available data, however, shows that HPN can be safely provided by caregivers and cancer patients. 38,39…”