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ESPEN practical guideline: Home parenteral nutrition
Loris Pironi1, Kurt Boeykens2, Federico Bozzetti3
1University of Bologna, Department of Medical and Surgical Sciences, Italy; IRCCS AOUBO, Centre for Chronic Intestinal Failure - Clinical Nutrition and Metabolism Unit, Italy.
Clinical Nutrition (Edinburgh, Scotland)
|February 16, 2023
Summary
This guideline provides evidence-based recommendations for safe and appropriate home parenteral nutrition (HPN) for healthcare providers and patients. It covers indications, device care, and program management for optimal HPN delivery.
Area of Science:
- Clinical Nutrition
- Gastroenterology
- Medical Guidelines
Background:
- Home parenteral nutrition (HPN) requires standardized protocols for safe and effective patient care.
- Existing guidelines need regular updates to incorporate current evidence and expert consensus.
Purpose of the Study:
- To provide comprehensive, evidence-based recommendations for the appropriate and safe provision of HPN.
- To inform healthcare professionals, administrators, policymakers, and patients about HPN best practices.
Main Methods:
- Systematic literature search using PICO format for meta-analyses, systematic reviews, and clinical trials.
- Evaluation of evidence quality and synthesis of expert opinion.
- Development of 71 clinical recommendations using Scottish Intercollegiate Guidelines Network methodology.
Main Results:
- The guideline addresses key aspects of HPN including indications, central venous access device (CVAD) management, nutritional admixtures, and program monitoring.
- It offers 71 updated recommendations based on current evidence and expert consensus.
- Recommendations cover CVAD and infusion pump selection, catheter and site care, and nutritional formulation.
Conclusions:
- This guideline offers a crucial update for optimizing home parenteral nutrition delivery.
- It aims to enhance the safety and efficacy of HPN for patients and providers.
- The recommendations support informed decision-making in HPN programs.
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