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Neoplastic diseases account for approximately one-half of all patients receiving home enteral nutrition, most of them with dysphagia due to the underlying cancer or antineoplastic therapies (malign a n t dysphagia). A review of t h e records of all patients with malignant dysphagia receiving home enteral nutrition for greater t h a n 1 year was undertaken. The following factors were identified: age, primary cancer, type of enteral access, calories received, duration of therapy, complications, a n d need for tube replacement. Eighty-two patients were studied. On average, patients received 1978 caVday (range: 500 to 3000) and were maintained on home enteral nutrition for 976 days (range: 367 to 3026). Complications a t the tube site were infection in 4 patients (4.8%) and significant leakage in 2 patients (2.4%). Average durability of the enteral access devices was pcrcutaneous endoscopic gastrostomies (PEG) = GOO days, low profile gastrostomy = 1701 days, percutaneous endoscopic jejunostomies (PEJ) = 591 days, low-profile jejunostomy = 902 days, and surgical jejunostomy = 1114 days. Home enteral nutrition is a safe and effective means of long-term nutritional support in patients with severe malignant dysphagia.

These results indicate that critically ill mechanically ventilated patients show improved respiratory mechanics with decelerating inspiratory waveform that may have beneficial clinical implication.