Home enteral and parenteral nutritional support: a comparison

Eighteen patients requiring intensive outpatient nutritional support were prospectively reviewed to compare the application of enteral and parenteral approaches. Nine patients received home enteral nutritional support (HEN) for a period of 2 to 15 months via Micro Feeding jejunostomy (MFJ) tubes. The other nine patients received home parenteral nutritional support (HPN) for a period of 3 of 32 months via Broviac catheters. The nine patients on HEN for a period of 2 to 15 months had a mean increase in weight, tricep skinfold thickness, arm muscle circumference, and serum albumin of 9.9 kg (p less than 0.001), 2.5 mm (p less than 0.01), 3.7 cm (p less than 0.05), and 0.73 g/dl (p less than 0.02), respectively. One patient suffered accidental loss of the MFJ tube; otherwise there were no significant complications. The nine patients on HPN for a period of 3 to 32 months had a mean increase in weight, triceps skinfold thickness, arm muscle circumference, and serum albumin of 8.5 kg (p less than .001), 3.5 mm (p less than 0.05), 3.4 cm (p less than 0.05), and 1.09 g/dl (p less than 0.001), respectively. Three patients each experienced one episode of catheter sepsis. These complications were far more serious than arising from the MFJ tube. In addition, the average cost of HPN was found to be 10 to 20 times greater than that of HEN. It is concluded that HEN should be selected over HPN as the course of therapy in all possible cases and that the MFJ tube is a safe, useful, and cost-effective approach.