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Paediatric Home Parenteral Nutrition in the Czech Republic and Its Development: Multicentre Retrospective Study

Jitka Stýblová1, Jana Kalousová, Miroslava Adamcová

  • 1Department of Paediatric Surgery, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, In Memoriam, Prague, Czech Republic.

Annals of Nutrition & Metabolism
|August 3, 2017
PubMed

Insights

Paediatric home parenteral nutrition (HPN) in the Czech Republic showed comparable outcomes to developed programs, with lower mortality in gastrointestinal cases. Most patients are now treated in specialized centers, improving care quality.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Nutrition
  • Healthcare Development

Background:

  • The development of a pediatric home parenteral nutrition (HPN) program in the Czech Republic.
  • Assessing treatment quality and patient outcomes during the program's formative years.

Purpose of the Study:

  • To evaluate the effectiveness and outcomes of a developing pediatric HPN program.
  • To compare results with established international HPN programs.
  • To analyze the impact of disease type and treatment centers on patient outcomes.

Main Methods:

  • Retrospective analysis of 66 pediatric patients receiving HPN between May 1995 and June 2011.
  • Data collected from 8 treatment centers.
  • Evaluation of patient demographics, disease types, catheter usage, weaning from HPN, survival rates, and catheter-related blood stream infections (CRBSI).

Main Results:

  • 48 patients started long-term PN in their first year of life; 35 in the first month.
  • 32% of patients were weaned from HPN, 33% continued HPN long-term, and 20% died while on PN.
  • Mortality was significantly lower in patients with gastrointestinal disease (60 patients) compared to non-gastrointestinal disease (6 patients).
  • CRBSI incidence was 1.58 per 1,000 catheter days in 2009-2010.

Conclusions:

  • Pediatric HPN care in the Czech Republic achieved outcomes comparable to well-established international programs, even without initially specialized centers.
  • A shift towards specialized centers has improved the standard of care for HPN patients.
  • The findings support the feasibility of developing robust HPN programs in diverse healthcare settings.
Abstract

Keywords:
ComplicationsDecentralized careHome parenteral nutritionPaediatricsShort bowel syndrome

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