
Home parenteral nutrition (HPN) is an essential therapy for those who can’t meet their nutritional requirements through oral intake or enteral feeding. It allows patients to receive total parenteral nutrition (TPN) at home, offering convenience and a better quality of life.
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As the reliance on hospital visits decreases, understanding the intricacies of HPN becomes crucial. If you are a new patient embarking on this journey, this guide is for you.
It will provide valuable insights into this treatment’s side effects, management techniques, and more. Keep reading to know what to expect when starting total parenteral nutrition.
What Is Home Parenteral Nutrition?
Home parenteral nutrition (HPN) is a medical therapy that delivers essential nutrients directly into the bloodstream via an intravenous (IV) catheter, bypassing the digestive system entirely. It’s recommended for those experiencing severe gastrointestinal dysfunction or malabsorption.
HPN is typically administered through a central venous catheter, such as a peripherally inserted central catheter (PICC) or tunneled catheter. The treatment is ideal for conditions like short bowel syndrome, chronic intestinal failure, or severe Crohn’s disease where oral or enteral feeding is not possible.
Studies show that parenteral nutrition offers a lower risk mortality among malnourished patients when compared to tube feeding.
The Components of Home Parenteral Nutrition
Patients receiving total parenteral nutrition at home rely on a carefully balanced mixture of nutrients to meet their daily requirements. The components of the TPN solution are tailored to each patient’s unique needs.
Here is an overview of what these mixtures typically include:
- Macronutrients: These compounds include carbohydrates, proteins, and fats that provide energy and support bodily functions.
- Micronutrients: Essential vitamins and minerals necessary for metabolic processes and overall health.
- Electrolytes: Important for maintaining fluid balance and proper cellular function, including sodium, potassium, and magnesium.
- Fluids: Ensure adequate hydration and help transport other nutrients throughout the body.
- Medications: May be included to address specific health needs or to prevent complications
Who Needs Home Parenteral Nutrition?
HPN is often essential for individuals with specific medical conditions that compromise their ability to absorb nutrients through traditional means. Below are some of the most common conditions that may necessitate HPN.
Crohn’s Disease
Crohn’s disease is an inflammatory bowel condition that can severely affect nutrient absorption, making HPN a crucial source of nutrition for affected individuals.
Ulcerative Colitis
Like Crohn’s disease, ulcerative colitis can lead to malnutrition due to the inability to digest food properly. HPN can help compensate for this deficiency.
Short Bowel Syndrome
Patients with this condition have a reduced intestinal length, limiting their ability to absorb nutrients effectively. Home parenteral nutrition ensures they receive the necessary nutrition directly into the bloodstream.
Ischemic Bowel Disease
This condition restricts blood flow to the intestines, impairing nutrient absorption. At-home total parenteral nutrition can provide a reliable source of nourishment while the digestive system heals.
Cancer
Many cancer patients experience significant weight loss and malnutrition as a side effect of chemotherapy. HPN can support their nutritional needs during treatment and recovery.
Preparing for HPN
Transitioning to home parenteral nutrition involves careful preparation to ensure a smooth experience. Here are some essential steps to prepare you for HPN.
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Initial Assessment and Education
Before starting HPN, your healthcare team will conduct a comprehensive assessment to determine your nutritional needs and sustainability for home treatment. This process involves evaluating your medical history, current health status, and the specific conditions necessitating HPN.
Afterward, your doctor will educate you on the benefits and potential challenges of HPN. The more you learn about the treatment, the better you can safely manage your therapy.
Setting Up a Home Environment
You must receive your home parenteral nutrition in a suitable environment. Dedicate a clean and organized space in your home for infusions. Ensure this place is quiet and away from pets and food preparation areas.
This area should include all your essential supplies, such as sterile equipment, an IV pole, and storage for TPN bags. Keep your TPN solutions in a dedicated refrigerator, ideally on the top shelf at the proper temperature.
Training for Patients and Caregivers
Proper training for patients and caregivers is vital for administering total parenteral nutrition at home. The healthcare team will provide detailed instructions on handling, preparing, and administering TPN solutions, along with guidelines for maintaining sterile techniques and identifying potential complications.
This knowledge helps build confidence in managing the infusion of home parenteral nutrition and enhances the overall care experience.
Importance of Support System
Having a support system around you can help make infusion sessions easier. A reliable support network will alleviate stress and foster a sense of community. Friends and family members can provide emotional support and practical assistance.
Communicating openly with your healthcare providers is also essential. They can offer guidance and address any concerns that may arise.
How Is HPN Administered?
HPN is delivered through a central venous catheter (CVC) that allows nutrients to be infused directly into the bloodstream. The frequency of administration depends on individual needs. Each infusion session can take anywhere from 10 to 24 hours.
These are the steps for administering home parenteral nutrition:
- Prepare the Workspace: Clean a designated area with disinfectant wipes to maintain sterility.
- Gather Supplies: Collect equipment, including TPN bags, syringes, and alcohol wipes.
- Check the TPN Solution: Inspect the bag for discoloration, cloudiness, or particles.
- Warm the Solution: Allow the TPN bag to reach room temperature prior to infusing.
- Wash Hands: Thoroughly wash your hands with soap and water before administering your at-home total parenteral nutrition.
- Connect the IV Line: Carefully attach the TPN tubing to the CVC as instructed by your healthcare provider.
- Start the Infusion: Run the program on the pump to administer TPN.
- Monitor the Infusion Rate: Regularly check for any redness or swelling around the catheter insertion area.
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About Copay AssistancePotential Risks of Home Parenteral Nutrition
While HPN is a vital therapy, it’s not without risks. Some of the potential side effects of TPN that may arise during treatment include:
- Infection at the Catheter Site: Caused by bacteria entering through the catheter.
- Thrombosis: Formation of blood clots in the vein.
- Electrolyte Imbalances: Disruptions in electrolyte level due to inadequate TPN formulation.
- Nutritional Deficiencies: If the TPN mixture is not formulated adequately.
- Metabolic Complications: Including liver damage or hyperglycemia.
Contact your healthcare provider immediately if you experience any signs of infection, fever, or unusual symptoms during treatment. Prompt action can help prevent more serious complications of TPN.
Managing Life With Home Parenteral Nutrition
Adjusting your life with TPN requires thoughtful planning and proactive management. Here are some key aspects for a smoother at-home total parenteral nutrition experience.
Daily Routines
Incorporating HPN into your daily routine may require some adjustments. Establish a consistent schedule for your infusions that fits your lifestyle. Whether during the day or overnight, administer each solution around the same hour every time.
Consider setting reminders for preparation and infusion. Plan your meals and other activities around these sessions. Make good hygiene and sterilization practices a part of your daily life.
All these commitments allow you to receive home parenteral nutrition safely and effectively.
Managing Side Effects
You may experience different side effects of TPN. However, there are effective strategies to minimize their impact and maintain a balanced life. Here are some tips to help you navigate these adverse effects:
- Stay Hydrated: If you are able to consume orally, drink plenty of fluids or receive hydration intravenously and monitor your hydration levels regularly.
- Maintain a Healthy Diet: If you are able to eat by mouth, complement HPN with a healthy diet approved by your healthcare provider.
- Stay Active: Incorporate low-impact exercises such as walking or biking to promote physical and mental health.
- Practice Good Hygiene: Follow strict hygiene practices when administering home parenteral nutrition to minimize the risk of infection.
- Follow Medication Plan: Take prescribed medications on time.
- Monitor Symptoms: Keep track of any side effects and report them to your doctor.
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Leader In TPN AssistanceRegular Monitoring and Follow-Up
Follow-ups with healthcare providers are vital for people receiving total parenteral nutrition at home. Visit your healthcare team regularly to assess your nutritional status and adjust your TPN formulation if necessary.
Your doctor will run blood tests and monitor your weight to ensure your current formulation provides you the necessary nutrients. They may also inspect the infusion site and provide tips for better administration of future home parenteral nutrition solutions.
Emotional and Psychological Considerations
Living with HPN comes with emotional challenges. To overcome these challenges, consider joining support groups. Connecting with people that have similar experiences can create a sense of understanding.
If you’re struggling with feelings of loneliness, depression, and anxiety, consider seeking professional counseling. Building a strong support network helps enhance emotional well-being and foster resilience throughout the treatment process.
Receive Total Parenteral Nutrition At Home With AmeriPharma® Specialty Pharmacy
Home parenteral nutrition can transform the lives of those who need nutritional support, providing a means to receive essential nutrients in a familiar setting. However, navigating life with HPN can be challenging for new patients.
By learning more about this therapy and its importance for your health, you can better manage your needs and actively participate in your care.
If you’re looking for reliable home infusion services, AmeriPharma® Specialty Pharmacy can help. Our URAC-accredited specialty pharmacy provides at-home total parenteral nutrition services in over 40 US states and territories.
Contact us to get started and receive home parenteral nutrition with full-service coordination, copay assistance, and 24/7/365 support.