Home enteral nutrition: A descriptive study

Abstract

Background: With data demonstrating benefit, the prevalence of home enteral nutrition (HEN) has increased significantly over the last few decades. Despite this increase, there remains a paucity of data regarding real-world use of HEN including clinical outcomes and complications.Methods: Descriptive analysis of prospectively maintained database of our specialized HEN program was undertaken. Patients who received care in our program with HEN initiation date between January 1, 2018, and December 31, 2020, were included in the analysis. Data regarding demographic information, anthropometrics, enteral nutrition (EN) regimen, electrolytes, and nutrition therapy history were included and tracked until July 31, 2021.Results: During the study period, 1600 patients initiated HEN treatment under our care. Majority of the study population needed EN therapy due to malignancy and its complications, including malignant dysphagia or mechanical obstruction (60.6%) followed by neurodegenerative diseases (7.5%). By the end of the study period, a majority of the patients (82%) stopped HEN treatment. Of these, 44.2% achieved EN goals and/or oral autonomy. Patients continued HEN treatment for a median of 100 (interquartile range, 32-301) days. Overall, 53.2% of patients experienced/reported at least one HEN-related complication that was clinically managed by the HEN team. Complications included tuberelated, enteral feeding intolerance (EFI), and electrolyte shifts. Conclusion:In our study population, HEN was most utilized to manage malignancyrelated complications, including dysphagia. Unfortunately, complications, including EFI and tube-related complications, remained quite prevalent. Further evaluation regarding risk factors for complications and preventive mechanisms, such as increased education, is indicated.

Peptide‐based formula: Clinical applications and benefits

“…The high prevalence of EFI has always been a concern and is frequently raised in various clinical reviews. A recently presented retrospective analysis of prospectively maintained large HEN cohort noted that one in five patients receiving HEN (20.5%) developed at least one symptom of EFI symptoms interrupting their EN 31 . Gungabissoon et al reported that around one in three patients who were critically ill who received EN developed EFI in a median of 3 days in a retrospective multicenter study evaluating EN‐tolerance profile in >150 ICUs 32 .…”

Frontier and hot topics in home enteral nutrition based on CiteSpace bibliometric analysis

“…Despite the effectiveness of HEN in promoting the recovery of gastrointestinal function and enhancing the immune system, practical challenges persist. Variability in self-management skills among patients and caregivers, coupled with the lack of a comprehensive community healthcare service system, often leads to a range of complications in patients receiving HEN, such as diarrhea, gastroesophageal reflux, aspiration, tube occlusion, rupture, displacement, and nutritional intolerance (5)(6)(7). To address these issues, the academic community has conducted numerous studies related to HEN in recent years.…”