Resumo

GUILLEN, N.; TORRENTO, M.; ALVADALEJO, R.  e  SALAS-SALVADO, J.. Assesment of the acceptance of set meals served at the "Sant Joan de Reus" University hospital. Nutr. Hosp. [online]. 2004, vol.19, n.5, pp.277-280. ISSN 1699-5198.

Despite the fact that, in most of the series published, cancer is the most frequent base pathology for the indication of home parenteral nutrition (HPN), the use of this technique in terminally-ill patients is still a controversial issue. Our goal has been to review the evolution of cancer patients with HPN treatment from "La Paz" Hospital with a view to studying the indication, evolution and complications. We review a total of 9 terminal oncological patients who had been treated with HPN between January 2000 and December 2002. with a mean age of 60.4 (44-81) years, the most common base cancer was gastric adeno-carcinoma (44%). Intestinal obstruction in the context of peritoneal carcinomatosis was the reason for indicating HPN in 89% of cases and the median survival time was 71 (23-131) days. Catheter infection was the most frequent complication with 1.4 episodes/patient. The existence of a Home Support Team meant follow-up of patients was easier, with HPN being estimated as the treatment provided in 67% of cases. 56% of the patients were not sufficiently informed as to their underlying illness. Although HPN is one more therapeutic resource, which may or may not be used in some terminal oncological patients, we must refine the indication as much as possible to take into account a series of "systematic guarantees" including fulfilment of pertinent clinical criteria, informed consent and the adoption of a collective decision with the involvement of all the professionals monitoring the patient. We propose an action algorithm to help in improving the decision-taking process in these patients.

Palavras-chave : Cancer; Home Parenteral Nutrition; Terminal Oncological Patients.

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