Total parenteral nutrition at home: studies in patients surviving 4 months to 5 years

Total parenteral nutrition at home has been delivered to 12 patients surviving for periods ranging from 4 months to 5 years. The route used is a silicone rubber catheter introduced into the superior vena cava. The mean survival of uncomplicated catheters is 15.8 months, but in 4 patients it is in excess of 28 months. The delivery system is a simple pneumatic infusor set, portable and safe to use, and not requiring complicated electronics. All patients have maintained ideal body weight and have been socially rehabilitated, with two exceptions. Detailed metabolic studies are presented and the data include routine biochemical analyses, liver function tests, liver biopsy results, blood aminograms, the plasma phospholipid fatty acid pattern, the plasma lipoprotein pattern, and blood vitamin and trace element profiles. Based on these findings a nutrient program is recommended and discussed.