Adult home parenteral nutrition: a clinical evaluation after a 3-year experience in a Southern European centre.

AIM: To evaluate the current use of Home Parenteral Nutrition (HPN) in a Southern European region. SUBJECTS AND METHODS: A total of 159 (86 m, 73 f) HPN patients, mean age 60.1 +/- 14.2 years, BMI 18.8 +/- 3.3kg/m2, consecutively referred to the Artificial Nutrition outpatient Unit of the Federico II University Hospital in Naples (Italy), from January 2000 to December 2002 and treated for at least 4 weeks. Retrospective evaluation of baseline disease, indications and duration of HPN treatment, type of venous access, complications. RESULTS: In all, 140 (88%) were cancer and 19 (12%) noncancer patients. Main indications were carcinosis in 68 for total, and hypophagia/dysphagia in 62 patients for partial/integrative (to oral-enteral nutrition) HPN; mean duration of HPN was 81.45 +/- 110.86 days of treatment and infection rate 2.89% in the whole population and 2.66% in the 36 patients treated for more than 3 months. No other major complications have been observed. CONCLUSION: HPN is confirmed to be a safe and effective treatment when prescribed and administered by a trained team.

Use and abuse of albumin: a survey of clinical records from an internal medicine ward.

BACKGROUND AND AIMS: This study was to review albumin prescriptions and indications in 4122 patients hospitalized in internal medicine wards in the years 1996, 1998 and 1999, before and after the ad hoc regulations issued in 1997 by the Italian Ministry of Health. METHODS: In 1996 (n=63), 1998 (n=59) and 1999 (n=55) 177 of these patients (4.3%) were given i.v. albumin. RESULTS: 161 (91%) of them had serum albumin values of <3.5 g/dl, while in only 36% were these values <2.5 g/dl. CONCLUSION: In the majority of cases albumin was erroneously prescribed, often to enhance diuretic efficacy or in protein energy malnutrition. Its prescription has not been influenced by the new recommendations.