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Catherine Lacroix, Geneviève Georges, Simon Thézenas

    Recherche En Soins Infirmiers
    |June 20, 2022
    PubMed
    Summary
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    Cancer patients receiving home parenteral nutrition (HPN) outside specialized centers experienced frequent infections. Improved adherence to care protocols and collaboration between HPN centers are crucial for better patient outcomes.

    Area of Science:

    • Oncology
    • Clinical Nutrition
    • Healthcare Management

    Context:

    • Home parenteral nutrition (HPN) management in France involves distinct healthcare systems based on duration (>12 weeks in specialist centers, <12 weeks outside).
    • Cancer patients often require HPN, necessitating careful management of associated complications.

    Purpose:

    • To prospectively assess infectious and vascular complications in adult cancer patients receiving HPN outside approved specialist centers.
    • To identify areas for improvement in HPN care for this vulnerable patient population.

    Summary:

    • A prospective study of 25 adult cancer patients (median age 63) receiving HPN outside specialist centers found high rates of infectious episodes (87% experienced chills/fever).
    • Most patients (79%) had significant weight loss, and 96% had low Ingesta scores, indicating malnutrition.

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  • One vascular complication (obstruction) was noted; the median time to first infectious episode was 11 days post-hospitalization.

    • Impact:

    • The high incidence of infectious episodes highlights a critical need for enhanced patient care and strict adherence to HPN guidelines.
    • Fostering collaboration and shared care protocols between approved specialist HPN centers could significantly improve patient management and reduce complications.