A 15-year audit of home parenteral nutrition provision at the John Radcliffe Hospital, Oxford

C.J. Green; V. Mountford; H. Hamilton; M.G.W. Kettlewell; S.P.L. Travis
May 2008
QJM: An International Journal of Medicine;May2008, Vol. 101 Issue 5, p365
Academic Journal
Background: Home parenteral nutrition (HPN) is an established option for patients suffering from intestinal failure, often pending definitive surgery, but sometimes for life or pending intestinal transplant. Care for patients with HPN is provided at centres other than designated intestinal failure units in the UK, but there are few data on outcomes. Aim: To audit the standard of care at one such centre using objective measures to compare with results published from other centres and intestinal failure units. Design: 15-year retrospective audit of paper and computer-based records of all HPN patients (1990–2004). Methods: Demographic data, major line and metabolic complication rates and mortality were collected and analysed. Results: 88 patients received HPN for a total period of 121 patient-years (median duration 217.8 days, range 18.3–3881.2, median age 40, range 3–73). Principal reasons for HPN were Crohns’ disease (35.2%), mesenteric, infarction (11.4%), surgical complications (17.0%), intestinal motility disorder (10.7%). The frequency of major complications were line sepsis (0.35 episodes/patient-year), line occlusion (0.25 episodes/patient-year), subacute bacterial endocarditis (0.02 episodes/patient-year), cholestasis (0.17 episodes/patient-year) and central venous thrombosis (0.03 episodes/patient-year). Indications and complications were all within the range of published data. Conclusions: HPN can be delivered effectively outside designated intestinal failure units and the current data are representative of a standard of care.


Related Articles

  • Rothia dentocariosa endocarditis with mitral valve prolapse: case report and brief review. Shakoor, S.; Fasih, N.; Jabeen, K.; Jamil, B. // Infection;Apr2011, Vol. 39 Issue 2, p177 

    The article presents a case study of a 37-year old man with mitral valve prolapse. The patient complained of fever of 38.8 degree celsius of unknown origin and underwent tests for malaria, dengue and urinalysis. Endocarditis was found with a rare pathogen called Rothia dentocariosa. The article...

  • Graduated compression stockings for the prevention of post operative venous thromboembolism.  // Australian Nursing Journal;Aug2008, Vol. 16 Issue 2, p31 

    The article offers information about post operative venous thromboembolism. Venous thromboembolism (VTE) is the forming of a blood clot in a vein. Most thrombi occur in the deep veins of the legs and this is called deep vein thrombosis (DVT). Formation of a DVT is associated with inactivity and...

  • When To Stop Warfarin Prior To Surgery: A Decision-Making Tool.  // Formulary;Jan1998, Vol. 33 Issue 1, p76 

    Presents the tool used by United Hospitals & Children's Health Care in Saint Paul, Minnesota for making anticoagulant decision prior to surgery. Procedure to take when both high bleeding risk and high clotting risk conditions are present; Safe condition in continuing anticoagulation throughout...

  • Hospital-Acquired Infective Endocarditis: Should the Definition be Broadened? Ben-Ami, Ronen; Giladi, Michael; Orni-Wasserlauf, Ruth; Siegman-Igra, Yardena; Carmeli, Yehuda // Clinical Infectious Diseases;3/15/2004, Vol. 38 Issue 6, p843 

    Hospital-acquired infective endocarditis (IE) is a growing health-care problem. Hospital-acquired IE, according to the commonly used definition, is IE manifesting ≥72 h after admission to the hospital or within several weeks after a hospital-based invasive procedure. To assess the validity...

  • Protean Faces of Infective Endocarditis in Renal Transplant Recipients. Ardalan, Mohammadreza // Nephro-Urology Monthly;Nov2014, Vol. 6 Issue 6, p1 

    A letter to the editor is presented in response to the article "Infective endocarditis after renal transplantation," by M. Moshkani Farahani and colleagues in the January 2014 issue.

  • Role of Factor VII in Correcting Dilutional Coagulopathy and Reducing Re-operations for Bleeding Following Non-traumatic Major Gastrointestinal and Abdominal Surgery. Tsai, Thomas C.; Rosing, James H.; Norton, Jeffrey A. // Journal of Gastrointestinal Surgery;Aug2010, Vol. 14 Issue 8, p1311 

    The objective of this study is to evaluate the effectiveness of rfVIIa in reducing blood product requirements and re-operation for postoperative bleeding after major abdominal surgery. Hemorrhage is a significant complication after major gastrointestinal and abdominal surgery. Clinically...

  • lesson of the month (2). U. Rao; M. O'Sullivan // Clinical Medicine;Dec2011, Vol. 11 Issue 6, p625 

    The article presents a case study of a 73-year-old man who suffered from endophthalmitis, a rare presentation of infective endocarditis (IE), two months after cardiac surgery. He developed intracerebral haemorrhage during treatment of endophthlamitis and died. Culture of tissue revealed the...

  • Fluid therapy with hydroxyethyl starch for massive blood loss during surgery. Suzuki, Toshinari; Miyao, Hideki; Terui, Katsuo; Koyama, Kaoru; Shiibashi, Michio // Journal of Anesthesia;2010, Vol. 24 Issue 3, p418 

    This clinical trial reports the use of hydroxyethyl starch (HES70/0.55/4) at very high dosages during surgery. HES70/0.55/4 has the lowest molecular weight among all HES products, and thus may have the least side effects. This observational retrospective study clarified the effects of high-dose...

  • Combining ultrasonic dissection and the Storz operation rectoscope. Lirici, M.M.; Paola, M.; Ponzano, C.; Hüscher, C.G.S.; Di Paola, M; Hüscher, C G S // Surgical Endoscopy;Aug2003, Vol. 17 Issue 8, p1292 

    Background: Transanal endoscopic microsurgery (TEM) allows a precise, full-thickness resection of rectal tumors anywhere within the rectum. Unfortunately, the standard TEM technique needs complex and rather expensive equipment, demands high skill, and is attended by bleeding and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics