Aktuelle Ernährungsmedizin 2017; 42(03): 241-272
DOI: 10.1055/s-0037-1603301
Poster
Georg Thieme Verlag KG Stuttgart · New York

HOME PARENTERAL NUTRITION (SWISSHPN-II STUDY): THE DESIGN OF A FOLLOW-ON INVESTIGATION WITH EMPHASIS ON THE EVALUATION OF CATHETER-RELATED COMPLICATIONS, ON PATIENTS' AND PHYSICIANS' QUESTIONNAIRES

E Aubry
1   Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital, and University of Bern, Bern
,
C Jeiziner
2   Department of Clinical Pharmacy and Epidemiology, University of Basel, Basel, Switzerland
,
C Aeberhard
1   Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital, and University of Bern, Bern
,
S Mühlebach
2   Department of Clinical Pharmacy and Epidemiology, University of Basel, Basel, Switzerland
,
Z Stanga
1   Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital, and University of Bern, Bern
› Author Affiliations
Further Information

Publication History

Publication Date:
20 June 2017 (online)

Also available ateRef
 

Introduction:

Home parenteral nutrition (HPN) is a long-term intravenous administration of nutrients and water to patients not able to meet their nutritional requirements by the oral and/or enteral route in a home setting1. It concerns only a few patients in Switzerland (prevalence 4 in 1 million habitants2). A central venous access is necessary. Catheter related complications (CRC) are relevant for the outcome. Therefore, measures to prevent are essential in this population. The most important problem is the catheter-related infection (CRI). A first nationwide prospective study over a 3 months period (SwissHPN-I2) took place in 2013/2014. The follow-on study over two years with follow-up periods of six months (SwissHPN-II) is now ongoing.

Objectives:

The aims are to collect data of current HPN patients in Switzerland, which will help to assess and optimize the quality of treatment to ensure patient's safety. Patient characteristics, social, psychological and somatic problems, anthropometric changes and medical history will be assessed and documented. Additional aspects emphasizing infectious and mechanical catheter-related and metabolic complications will be collected. The nationwide data collection of HPN patients is mandatory to observe positive and negative developments of this population over time.

Methods:

An extensive literature search on CRC was undertaken. The questionnaires and study protocol were processed using internal expert evaluation rounds. A pilot study was conducted to the study concept.

Results:

A total of 5 patients and 5 physicians were included in the pilot study. Infections were the most frequent CRC, in 60% of the patients (n = 3), causing hospitalization, vancomycin treatment and catheter removal. Catheter related venous thrombosis and mechanical complications occurred in 40% of the patients (n = 2).

Conclusion:

This SwissHPN-II study will allow a detailed overview on HPN patients' characteristics, underlying diseases, therapy indications and living situation. In the current pilot study it became clear that it is very important to assess all CRC, because they make a major contribution to an affected quality of life.

References:

[1] Staun M, Pironi L, Bozzetti F, et al. ESPEN Guidelines on Parenteral Nutrition: Home Parenteral Nutrition (HPN) in adult patients. Clin Nutr. 2009;28(4):467 – 479.

[2] Aeberhard C, Leuenberger M, Joray M, Ballmer PE, Mühlebach S, Stanga Z. Management of home parenteral nutrition: a prospective multicenter observational study. Ann Nutr Metab. 2015;67(4):210 – 217.

Disclosure of Interest:

None declared.