1. Paediatric Home Parenteral Nutrition in the Czech Republic and Its Development: Multicentre Retrospective Study 1995-2011
- Author
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Kateřina Bajerová, Petra Keslova, Oldřich Pozler, Filip Fencl, Jan Melek, Ladislav Tomášek, Astrid Šuláková, Jana Tejnická, Jiří Bronský, Eva Karásková, Václav Sebroň, Peter Tláskal, Jana Kalousová, Jitka Stýblová, Miroslava Adamcová, Barbora Vlková, Peter Szitányi, and Intensive Metabolic Care
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Medicine (miscellaneous) ,Disease ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,medicine ,Humans ,Child ,Paediatric patients ,Czech Republic ,Retrospective Studies ,Nutrition and Dietetics ,business.industry ,Incidence (epidemiology) ,Incidence ,Infant ,Retrospective cohort study ,medicine.disease ,Short bowel syndrome ,Catheter ,Parenteral nutrition ,Treatment Outcome ,Gastrointestinal disease ,Catheter-Related Infections ,Child, Preschool ,030211 gastroenterology & hepatology ,Female ,business ,Parenteral Nutrition, Home - Abstract
Background: Treatment quality and outcomes of paediatric home parenteral nutrition (HPN) program during its development in the Czech Republic. Methods: A retrospective study of patients receiving HPN from May 1995 till June 2011. Results: Sixty-six patients were treated in 8 centres. In 48 patients, long-term PN began in the first year of life and in 35 of them in the first month. Sixty children had gastrointestinal and 6 had non-gastrointestinal disease. In a majority of the patients, the Broviac catheter was used. Thirty-two (48.5%) patients were weaned from PN after 1-117 months, 21 (32.8%) continued on HPN after 7-183 months, and 13 (19.7%) patients died, all on PN. The mortality in patients with primary gastrointestinal disease was significantly lower than in patients with non-gastrointestinal disease. Thirty-one paediatric patients were receiving HPN for 14,480 catheter days in 2009-2010. Fourteen patients had 23 Catheter Related Blood Stream Infections (CRBSI) episodes. The incidence of CRBSI in 2009-2010 was 1.58/1,000 catheter days. Conclusion: Submitted data showed that even in the absence of expert centres, patient care may achieve results comparable to countries with well-developed HPN program. A majority of Czech HPN patients are at present treated in specialized centres, following the most desirable pattern of care.
- Published
- 2017