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Risks and Benefits of Home Parenteral Nutrition in the Acquired Immunodeficiency Syndrome

Division of Critical Care Medicine, Department of Anesthesiology, Montefiore Medical Center and The Albert Einstein College of Medicine, Bronx, New York, Section on Critical Care/Nutrition, Medical Service, Veterans Administration Medical Center, East Orange, New Jersey

Michael M. Rothkopf, M.D.

Division of Critical Care Medicine, Department of Anesthesiology, Montefiore Medical Center and The Albert Einstein College of Medicine, Bronx, New York, Section on Critical Care/Nutrition, Medical Service, Veterans Administration Medical Center, East Orange, New Jersey

Vladimir Kvetan, M.D.

Division of Critical Care Medicine, Department of Anesthesiology, Montefiore Medical Center and The Albert Einstein College of Medicine, Bronx, New York, Section on Critical Care/Nutrition, Medical Service, Veterans Administration Medical Center, East Orange, New Jersey

Olli Kirvelä, M.D., PH.D.

Division of Critical Care Medicine, Department of Anesthesiology, Montefiore Medical Center and The Albert Einstein College of Medicine, Bronx, New York, Section on Critical Care/Nutrition, Medical Service, Veterans Administration Medical Center, East Orange, New Jersey

Judith Gaare, M.S., R.D.

Division of Critical Care Medicine, Department of Anesthesiology, Montefiore Medical Center and The Albert Einstein College of Medicine, Bronx, New York, Section on Critical Care/Nutrition, Medical Service, Veterans Administration Medical Center, East Orange, New Jersey

Jeffrey Askanazi, M.D.

Division of Critical Care Medicine, Department of Anesthesiology, Montefiore Medical Center and The Albert Einstein College of Medicine, Bronx, New York, Section on Critical Care/Nutrition, Medical Service, Veterans Administration Medical Center, East Orange, New Jersey

The gastrointestinal tract is a major target of the human immunodeficiency virus. Many AIDS patients have weight loss and/or diarrhea. Parenteral nutrition can be used to treat malnutrition associated with malabsorption. We reviewed retrospectively the clinical course of 22 patients with AIDS and weight loss greater than 10% who received home parenteral nutrition (HPN) for 56.2 patient-months. Mean weight loss was 21.4%, mean duration of HPN 2.55 months, mean age 37.4 years. Fifteen patients gained weight, six stabilized and two continued to lose weight. Nine patients returned to previous activity. Five died. The rates of catheter-related sepsis, complications, and metabolic disturbances were 0.12, 0.25, and 0.12/100 catheter days, respectively, results identical to those reported in other patient populations where HPN is commonly applied. We found that HPN induced weight gain and clinical improvement in most patients without higher risks of sepsis than in patients with malignancies. (Journal of Parenteral and Enteral Nutrition 15:75-79, 1991)

Journal of Parenteral and Enteral Nutrition, Vol. 15, No. 1, 75-79 (1991)
DOI: 10.1177/014860719101500175


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