Total Parenteral Nutrition at Home for 23 Months, Without Complication, and With Good Rehabilitation: A study of technical and metabolic features

We document the experience of our 1st patient with permanent total parenteral nutrition, currently extending to 32 months, the last 23 months being spent at home. We do so because of the success of the home-care program which includes excellent rehabilitation of a vigorous 36-year-old housewife and mother of three youngsters, living on a farm 100 miles from "her centre." The important features of this patient are: (1) the survival for 30 months, at present, of the indwelling Silastic catheter without complication, including evidence of infection, (2) the simple pressure infusion system which avoids pumps, alarms, and dependence on electricity, (3) maintenance of weight and nitrogen balance on relatively modest calories amounting to 34 kcal per kg per day, (4) the need for lipid infusion to prevent the development of fatty liver, (5) extensive studies embracing fat and amino acid metabolism over an extended period of time in a subject who feels well, and is active and asymptomatic.