Home Parenteral Nutrition

Many patients are able to receive PN in the home setting. If the patient's medical condition is stable and careful patient selection has been employed, home parenteral nutrition (HPN) can be considered. The patient and caregiver must be able to be taught to use an infusion device, administer PN safely, and search for signs of infection, fluid issues, or other complications. Appropriate education should begin in the hospital and continue in the home setting. Psychosocial and socioeconomic issues, such as family support, private or government payer status, and patient emotional status, are important to consider when assessing the appropriateness of HPN.

Nocturnal administration of PN over 12 h can aid with patient mobility and quality of life and may also help to minimize hepatobiliary complications. Cycled PN infusion should generally begin in the inpatient hospital environment so tolerance of cycling can be safely evaluated. Since greater infusion rates are required for cycling, close monitoring during the transition phase is of particular importance for those with glucose or volume tolerance concerns.

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