Home parenteral nutrition: present management, future options

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Abstract
Home parenteral nutrition (HPN) is increasingly being used for paediatric patients with intestinal failure, providing a remarkable improvement in quality of life. To enable the institution of HPN and its subsequent management these patients need to be looked after by both specialist centres and the primary care team. Information sources about this group of patients is available on a British Registry, run by the British Association for Parenteral and Enteral Nutrition. HPN is a complicated technique, which carries risks that may be life-threatening. Avoidance of complications depends primarily on the child’s management by multidisciplinary teams. Whilst families can manage this treatment at home, many psychosocial problems arise – fatigue and financial problems are common. Bowel transplantation is now recognised as an option for some children with severe irreversible gastrointestinal failure who develop complications of parenteral nutrition.

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