Nutrizione parenterale domiciliare: 11 anni di esperienza

We present a 11 years analysis (1983-1994) of the management of 79 Home Parenteral Nutrition patients, for a total amount of 29,877 days, (378 days/patient;range 22-3278). All patients were affected by absolute or relative gut failure. 34 patients (43%) were oncological, and underwent a cumulative of 4673 days of HPN (137 ± 107 days/patient): all neoplastic patients died. 45 patients presented benign diseases and they have performed an amount of 25,204 days of treatment (586 ± 761 days/patient); 29 of them came back to oral feeding, 7 died because of their pathology, 9 are still in HPN. Catheter complications; - 39 catheter related sepsis (1.3/1000 days); - 5 catheter occlusions (0.16/1000 days);-2 thrombophlebitis (0.06/1000 days);-5 catheter breakages (0.17/1000 days), 3 subcutaneous tunnel infections (0.10/1000 days); - 1 decubitus lesion in totally implanted catheter camera Port (0.03/1000 days). Clinical metabolic complications; - 3 Zn deficit dermatitis (0.10/1000 days); - 2 serious bone demineralizations (0.06/1000 days); - 2 hepatopathies (0.06/1000 days). Our experience shows that: - HPN needs an organized structure and a nutritional support team; - it has to be performed in gut failure only; - HPN is a safe therapy and it allows many patients to survive intestinal insufficiency, offering them a good quality of life; - HPN doesn't influence pathology progression in neoplastic patients and it should be performed whenever the nutritional therapy can improve their quality of life.