Home InfusionTherapy

26

6

IN OUT !

!

!

!

!MNA SGAODA!!

HPN! !

HEN!

!

Home Infusion TherapyHITHome Parenteral Nutrition HPN

High output

PPN

Why?

How?

PICCperipherally inserted central venous catheter CV

1. 2. 3. 4.

2000

PPN

TPN

YES NO

ASPEN

Q Q

QpH

mOsm/kg

6001.95 4506001.461.95 3404501.101.46

2403400.781.10 2400.78

pH 4.10 7.35

7.337.35 7.45 8.00

15mmHg

CV

PICCperipherally inserted central venous catheter

CV

BroviacAHickmanB

CVC IVH TPN PPN HPN HEN

Central Venous Catheter Intravenous Hyperalimentation Total Parenteral Nutrition Peripheral Parenteral Nutrition Home Parenteral Nutrition Home Enteral Nutrition

TPN TPN 1. 2. 1. 2. 1. 2.

123

TPN

1

1

-(Harris-Benedict Equation) BEE = 66.4730 13.7516w 5.0033h - 6.7550a BEE = 655. 0955 9.5643w 1.8496h - 4.6756a w:(kg)h:(cm)a:()

2530kcal kg dayBEEADL1030NPC/N150

kcalmL

1 2000mL1

-1.2 1.3

COPD

!

1.00 1.151.30 1.101.30 1.101.30 1.201.40 1.202.00 1.202.00

Long chain triglycerideLCT

-

20100ml

(20%) 100ml 50kg !(20%) 100ml 1 100ml0.2=20g

0.1g/kg/hr=20/50/x X=20/(500.1)=4

2ml10%ml

NPC/Nkcal g

-

NPC/N150

g150

2.

3.

Y

1.

4.

A

BC

D

AB

1,880

CPI-system

62 168cm55kg

1) 2) 3) 4) 5) ADL 6)

ADL

Thats not what you said..

-

-

-

COPD

Evans WJ, Morley JE, Argiles J, Bales C, Baracos V, Guttridge D, et al. Cachexia: a new definition. Clin Nutr. 2008 Dec;27(6):793-9.

Cachexia

Cachexia Diagnosis

5%/12

BMI

Fearon K, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011 Feb 4.

Pre-cachexia

Cachexia

Refractory cachexia

5%

5% BMI2% >2%

Performance status 3

Classification of cachexia

QOL

PATIENT-CENTERED OUTCOME

POINT

11.5g/kg/ 6.8g/kg/ 1.4g/kg/

NPC/N 200250

-K

-P

NC-NL PL L / LL PL25mg 5mg

NPC/N=240

25mL/hr 24

2,0002,50010,000 !

TPN1017NPC/N200250

2 175cm55kg

1

Quality of Life Patient-Centered Outcomes International Classification of Functioning

STOP & GO