| Autor: |
Moreno Villares JM; Clínica Universidad de Navarra., Virgili-Casas MN; Servicio de Endocrinología y Nutrición. Hospital Universitari de Bellvitge., Ashbaugh Enguídanos R; Unidad de Nutrición Clínica y Dietética. Servicio de Endocrinología y Nutrición. Hospital Universitario Príncipe de Asturias., Wanden-Berghe C; Hospital General Universitario de Alicante. ISABIAL-FISABIO., Cantón Blanco A; Servicio de Endocrinología y Nutrición. Complejo Hospitalario Universitario de Santiago de Compostela (CHUS)., Álvarez Hernández J; Unidad de Nutrición Clínica y Dietética. Servicio de Endocrinología y Nutrición. Hospital Universitario Príncipe de Asturias., Bretón I; Nutrition Unit. Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón., Del Olmo D; Hospital Universitario Severo Ochoa., Ferrero López I; Hospital Pare Jofré., Lozano Fuster FM; Hospital Universitario Son Espases., Molina Soria JB; Servicio de Medicina Interna. Hospital Universitario San Agustín. |
| Jazyk: |
Spanish; Castilian |
| Zdroj: |
Nutricion hospitalaria [Nutr Hosp] 2024 Feb 15; Vol. 41 (1), pp. 255-261. |
| DOI: |
10.20960/nh.05042 |
| Abstrakt: |
Introduction: Background: patients with cancer are one of the main group of patients on home parenteral nutrition (HPN). Patients with malignant bowel obstruction (MBO) represent a challenging group when considering HPN. At the Ethics Working Group of SENPE ethical considerations on this subject were reviewed and a guidelines proposal was made. Methods: a literature search was done and a full set of questions arose: When, if ever, is HPN indicated for patients with MBO? How should the training program be? When withdrawal of HPN should be considered? Other questions should be also taken into consideration. May any Oncologist send home a patient with HPN? The educational program could be shortened? When considering to withdraw parenteral nutrition? Results: HPN in MBO has better outcomes when patients have a good functional status (Karnofsky ≥ 50 or ECOG ≤ 2), expected survival > 2-3 months, and low inflammatory markers. Very few data have been reported on quality of life, but HPN allows a valuable time at home albeit with a considerable burden for both patients and their families. Proposal: once a patient is considered for HPN, there is a need for a deep talk on the benefits, complications and risks. In this initial talk, when HNP should be stopped needs to be included. The palliative care team with the help of the nutrition support team should follow the patient, whose clinical status must be assessed regularly. HPN should be withdrawn when no additional benefits are achieved. Conclusion: HPN may be considered an option in patients with MBO when they have a fair or good functional status and a desire to spend their last days at home. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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