Home Nutrition Support In Pediatric Patients

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. The average weight z-score at the beginning of the HNS program was -1.4(-4.4 to 1.3). At 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.