Maintenance of home hyperalimentation in patients with high-output jejunostomies

We studied four patients with high-output end jejunostomies (greater than 3,000 mL/day) who were receiving home hyperalimentation. With knowledge of urine and stoma output, standard total parenteral nutrition fluid was infused and titrated according to individual needs, first during the hospital stay and then on follow-up office visits. Mean daily stoma output for the group was 3,556 mL/day. With oral fluid intake restricted to 1,500 mL/day, average daily stoma output dropped to 2,892 mL. The mean daily volume of nutrient fluid required to achieve stabel biochemistries and weight was 3,550 mL. Daily caloric requirements ranged from 23 kcal/kg to 44 kcal/kg, with a mean of 32.5 kcal/kg. Amino acid requirements averaged 1.6 g/kg. With 65 patient months of continuous overnight catheter infusion, there have been no serious metabolic derangements or deaths. The program of home hyperalimentation can maintain a satisfactory metabolic state in patients with high-output jejunostomies.