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picture1_Nutrition Ppt 80861 | B Mille Palliative Care Registrar Teaching  Hpn In Advanced Abdominal Ca V2


 200x       Filetype PPTX       File size 1.00 MB       Source: nwpgmd.nhs.uk


File: Nutrition Ppt 80861 | B Mille Palliative Care Registrar Teaching Hpn In Advanced Abdominal Ca V2
aims discuss parenteral nutrition pn in intestinal failure related to advanced abdominal cancer christie referral pathway for hpn review some of the practicalities involved for patients receiving hpn not covering ...

icon picture PPTX Filetype Power Point PPTX | Posted on 08 Sep 2022 | 3 years ago
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           Aims
  • Discuss parenteral nutrition (PN) in intestinal 
   failure related to advanced abdominal cancer
  • Christie referral pathway for HPN
  • Review some of the practicalities involved for 
   patients receiving HPN
  • Not covering PN in cancer cachexia
                            Background
     • Home Parenteral Nutrition (HPN) in advanced malignancy is 
        becoming increasingly common
            2005 2006 2007 2008      2009  2010 2011    2012 2013 2014 2015
 Total      n=    n=    n=    n=     n=    n=    n=     n=    n=    n=    n= 
            112   101   138   157    148   228   262    351   472   400   420
 Malignancy 13    17    16    24     14    32    43     66    116   102   115
                             New adult HPN registrations, 2005 and 2015
     • Lack of consensus throughout the world, with the 
        proportion of HPN patients with cancer as the indication up 
        to 60% in some parts of Europe (Naghibi et al, 2014)
    BANS report on Adult Home Parenteral Nutrition & Home Intravenous Fluids, 2016
                            IFU SRFT - referrals
        Year                              Total referrals to IFU     Total referrals for remote D
        2009 – 10                                  147                               
        2010 – 11                                  121                               
        2011 – 12                                  126                               
        2012 – 13                                  152                             13
        2013 – 14                                  156                             7
        2014 - 15                                  146                             16
        15 - 16                                    171                             15
        16 - 17                                    180                             32
        17 - 18                                    195                             43
        18 - 19                                    198                             57
                Primary malignancy
                                         Gastro-intestinal n=16
                                         Gynaecology n=29
                                         other n=13
                                         pseudomyxoma n=5
        Others:
              - Lymphoma        -  Carcinoid
              - Mesothelioma    -  Urology
              - Pancreatic
         Background
  • Failure to maintain weight and nutrition is 
   common in patients with cancer
  • In those with a functioning and accessible GI 
   tract, use oral/enteral route of nutrition
  • In those with intestinal failure secondary to 
   advanced abdominal malignancy (e.g. 
   inoperable malignant bowel obstruction)  
   consider parenteral nutrition
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