Inflammatory mediators and home parenteral nutrition

Individuals who have sustained intestinal failure due to trauma or disease are able to survive through the use of parenteral nutrition (PN). Although home PN (HPN) is a lifesaving therapy, patients may, over the long term, be at risk for liver, bone, and immune dysfunction. A limited number of human studies and a large number of animal studies suggest that there may be a chronic inflammatory condition and additionally a potentially lower T-lymphocyte immune function associated with PN administration. This article will primarily focus on a review of the limited clinical literature that examines the effect of long-term PN on the occurrence of inflammatory mediators in HPN patients, and will discuss the factors that are currently hypothesized to contribute to the potential inflammatory sequelae.