Intravenous literature: Wanten, G., Calder, P.C. and Forbes, A. (2011) Managing adult patients who need home parenteral nutrition. BMJ. 342, p.696-701.
Home parenteral nutrition is the treatment of choice for patients with long term intestinal failure It should be supervised by an experienced team that trains patients in best management In some patients it is associated with substantial impairment in quality of life Survival is mainly determined by the primary disease
The main problems stem from venous access related complications Liver dysfunction and altered bone mineralisation are common adverse effects
New strategies to improve outcomes include use of intestinotrophic factors to promote intestinal adaptation and new lipid formulations to modulate immune function