[Our experience of home parenteral nutrition (HPN) for digestive disease patients]

The number of patients receiving home parenteral nutrition (HPN) has been increasing mainly among end-stage cancer patients. In our hospital, twenty-four patients received HPN therapy with digestive disease from April 1995 to May 1998. Most of them were in the terminal stage of advanced gastric cancer. Many patients received other treatments such as narcotics, blood transfusion, chemotherapy, and so on with HPN. Their average age was 71 years old. The duration of HPN varied from 4 to 180 days (mean: 50.9 days). The duration of intravenous hyperalimentation varied from 14 to 300 days (mean: 98.2 days). The duration from insertion of catheter to discharge varied from 0 to 75 days (mean: 24.8 days). We have provided HPN guidance to patients and their families with pamphlets and checklist before discharge. Nurses play an important role in introduction of HPN. But some patients could not to be treated with HPN because of family factors, their wish to be in the hospital, and so on. We consider the following important in order to carry out HPN more smoothly. 1) Early selection of patients for HPN. 2) Early lecture for methods of HPN to patients and family. 3) To know and prepare familial environment. 4) Try to stay home overnight with IVH repeatedly. 5) Establishment of home care system on call for emergencies. 6) To keep in close contact with other services in the area.