Home parenteral nutrition in adults : the current use of an experienced method

Home parenteral nutrition (HPN) is now commonly used in industrialized countries. In Europe, the mean incidence of newly enrolled cases is about 3 patients per 106 inhabitants, per year. The use of HPN is much larger in North America. Cancer has become the largest single indication of HPN over the world. The complications are either related to the central catheter (sepsis, thrombosis, migration) or metabolic (liver abnormalities, bone disorder, deficiencies). Complications rate may be lowered by an adequate nutritional regimen, a good teaching of the patients and the presence of a nutritional team in specialized centres. The survival probability for patients with benign diseases is about 65% at 5 years. The mortality rate related to HPN itself is less than 10%. For patients with benign diseases, weaning of HPN is observed in 40 to 70% of the cases. Sixty percent of the patients have a very good quality of life. HPN must be used selectively in cancer patients.