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Home parenteral nutrition: results in 34 pediatric patients
Insights
Home parenteral nutrition (HPN) is a safe and effective treatment for children with digestive disorders. This therapy improves nutritional status, reduces symptoms, and allows children to resume normal activities and education.
Area of Science:
- Pediatrics
- Gastroenterology
- Nutrition
Background:
- Home parenteral nutrition (HPN) is established for adults but lacks extensive pediatric data.
- Severe digestive disorders in children often necessitate advanced nutritional support.
Purpose of the Study:
- To evaluate the safety and efficacy of HPN in pediatric patients.
- To assess the impact of HPN on nutritional status, growth, and quality of life in children.
Main Methods:
- A cohort of 34 pediatric patients (1.5 months to 20.5 years) received HPN via Silastic Broviac catheters.
- Infusions were administered daily over 10-14 hours using volumetric pumps.
- Follow-up periods ranged from 23 to 786 days.
Main Results:
- All patients showed improved nutritional status and reduced symptomatology.
- 23 of 29 patients on HPN for over two months experienced increased height.
- Patients resumed daily activities, including education and work.
Conclusions:
- HPN via Broviac catheter is a safe and successful method for pediatric patients with severe digestive disorders.
- HPN supports optimal nutrition, growth, and lifestyle normalization in children.
- HPN can facilitate bowel adaptation and oral alimentation post-therapy.
Abstract:
Although home parenteral nutrition (HPN) has been used successfully for adult patients, no extensive experience with children has been reported. During the past three years, we have managed 34 patients, ages 1 1/2 months to 20 1/2 years, on a HPN program for periods ranging from 23 to 786 days. Silastic Broviac catheters were inserted into the superior vena cava through the jugular or cephalic veins or into the inferior vena cava through the saphenous vein. The catheters were brought out onto the chest or lower abdominal wall through a subcutaneous tunnel. Solutions were infused over a 10--14-hour period each day, using a volumetric pump system. All patients improved their nutritional status. Twenty-three of 29 on the program for more than two months showed an increase in height. All patients evidenced a significant decrease in symptomatology. All resumed per group activities while on HPN and were able to continue their education or work. At present 24 patients including 15 with Crohn's disease no longer receive HPN. Administration of HPN through a Broviac catheter is a safe, successful technique for maintaining an optimal nutritional status in children with severe digestive disorders, and permits resumption of a more normal daily lifestyle. Following HPN, bowel adaptation and initiation of full oral alimentation become possible in many patients.