Home nutrition support in pediatric patients

Abstract

The aim of the study is to evaluate the feasibility and effectiveness
of a Home Nutrition Support (HNS) program in a
heterogeneous group of pediatric patients. Patients- methods:
The medical records of 44 pediatric patients median
29(range 2m to 11,5y), enrolled in the program of Home
Nutrition Support (HNS) immediately after hospital discharge,
were reviewed. Data recorded during the regular
follow-up (clinical profile, serial anthropometric measurements,
quantitative and qualitative adaptation of the nutrition
solutions during transitional periods) were assessed.
Results: The clinical conditions supported were: surgical(
19), non-surgical(25). HNS was delivered by oral intake(
36), by nasogastric tube(5) and through gastrostomy(
3). The duration of HNS ranged from 1.5-74 months
(mean 26m). Three patients died from causes not related
to HNS and 4 are expected to be HNS-dependent for life.
Complications were documented in 30% of patients. �he
average weight z-score at the beginning of the HNS program
was -1.4(-4.4 to 1.3). �t the completion of the HNS
program it was -0.5(-2.2 to 1.9). Weight and height velocity
were improved in 75% and 65% of cases, respectively.
There was a statistically significant difference in z-score
improvement between surgical and non-surgical patients
(p<0,05) and between patients with and without complications
(p<0.05). There was statistically significant negative
correlation between z score improvement and patient's
age(p<0.05) but no correlation with the duration of HNS.
Conclusions: HNS is feasible and effective, in the management
of serious chronic diseases in pediatrics. Pediatric
patients can easily tolerate the oral intake of nutrition solutions.
Younger patients and those with surgical problems
seem to benefit the most. Patients' growth velocity during
HNS is hampered by concomitant complications.