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- W1566149037 abstract "Abstract Nineteen adult patients with severe malnutrition received cyclic nocturnal home parenteral nutrition (HPN) for a total duration of 485 patient-months. Malnutrition had resulted from severe short bowel syndrome (13 patients), extensive Crohn's disease (4 patients), amyloidosis with pseudoobstruction (1 patient), and a combination of celiac sprue and a Whipple procedure (1 patient). The length of small bowel remaining in the short bowel group ranged from 0 to 155 cm with an average of 80 cm. Nutritional indices before HPN included mean weight/ height of 72% of ideal; serum albumin, 2.6 g/dl; urinary creatinine/height index, 51 ± 22% of ideal; urinary nitrogen of only, 3.7 ± 1.6 g/day; and depressed serum measurements of electrolytes and macroelements. After the patients had received HPN for an average of 25.5 mo (3–90 mo), weight was usually normalized (mean of 95% ideal body weight) and nutritional indices—visceral protein (mean increase in albumin of 1.1 g/dl), skeletal muscle mass (increase in urinary creatinine/height index from 51% to 93% of ideal), and serum macroelements and electrolytes —confirmed improvement. Serial studies of body composition in 4 patients showed that distribution of weight gain was equally distributed between fat and lean body mass. Six of 7 patients who had residual Crohn's disease of the small bowel when HPN was begun required additional surgery for the disease. Twelve of 18 surviving patients have been socially rehabilitated; 6 patients are still disabled by combinations of their primary disease, narcotic dependence, and depression. Major complications included damage to the external segment of nine catheters, which were repaired on an outpatient basis, and four documented catheter-related infections—one infection per 10 patient-years of HPN. The benefit-to-risk ratio for HPN is high, and the method is now the treatment of choice for patients who have little hope of having adequate nutrition restored by oral means." @default.
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- W1566149037 date "1980-07-01" @default.
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- W1566149037 title "Home parenteral nutrition for management of the severely malnourished adult patient" @default.
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- W1566149037 doi "https://doi.org/10.1016/0016-5085(80)90068-2" @default.
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