Home Parenteral Care

  • Abdullah Shatnawei
  • Shishira Bharadwaj
  • Denise Konrad
  • Sandra Austhof
  • Ronelle Mitchell
Living reference work entry

Abstract

Home parenteral nutrition (HPN) is a life-sustaining medical nutrition therapy that is utilized in patients who are unable to maintain adequate nutrition and hydration through enteral sources and their medical condition no longer requires hospitalization. It is a costly therapy with insurance coverage differing among policies, and patients often have some out-of-pocket expense. Management of HPN starts while the patient is still hospitalized. A specialized, multidisciplinary nutrition support team (NST) is crucial in the safe transition from hospital to home. Many factors are considered including the length of therapy, type of central venous access device (CVAD), patient or caregiver’s ability to perform PN procedures, and overall plan of care. Regular laboratory tests along with intake and output records aid in effectively managing this therapy. Though HPN is crucial for this patient population, it is not without concern for complications ranging from infection to metabolic or mechanical etiologies. However, a knowledgeable NST can safely monitor patients at home on parenteral nutrition (PN) to reduce complications while providing freedom from the hospital.

Keywords

Phosphorus Hydration Osteoporosis Insurance Coverage Heparin 

Abbreviations

ALT

Alanine aminotransferase

AST

Aspartate aminotransferase

BUN

Blood urea nitrogen

CRBSI

Catheter-related bloodstream infection

CNS

Central nervous system

CPN

Central parenteral nutrition

CVAD

Central venous access device

CBC

Complete blood count

CMP

Complete metabolic panel

DVT

Deep vein thrombosis

ECG

Electrocardiogram

EFAD

Essential fatty acid deficiency

GI

Gastrointestinal

g

Gram

HPN

Home parenteral nutrition

HCl

Hydrochloric acid

IV

Intravenous

Kg

Kilogram

PN

Parenteral nutrition

PICC

Peripherally inserted central catheters

PPN

Peripheral parenteral nutrition

mEq

Milliequivalent

mg

Milligram

NST

Nutrition support team

RN

Registered nurse

NaHCO3

Sodium bicarbonate

NaOH

Sodium hydroxide

SVC

Superior vena cava

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Copyright information

© Springer Science and Business Media New York (outside the USA) 2014

Authors and Affiliations

  • Abdullah Shatnawei
    • 1
  • Shishira Bharadwaj
    • 2
  • Denise Konrad
    • 3
  • Sandra Austhof
    • 3
  • Ronelle Mitchell
    • 3
  1. 1.Department of Gastroenterology and HepatologyThe Cleveland Clinic, Digestive Disease InstituteClevelandUSA
  2. 2.Cleveland Clinic, Digestive Disease InstituteClevelandUSA
  3. 3.Center for Human NutritionCleveland Clinic, Digestive Disease InstituteClevelandUSA

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