Poster (15W139)

The impact of aetiology and age on long term outcomes in Irish children on home parenteral nutrition


Rebecca Stanley¹, Tara Raftery2,4, Sheila Sugrue¹, Michelle Hurley², Anthea Bryce-Smith², Annemarie Broderick2-4, Billy Bourke2-4, Séamus Hussey2-4


1School of Biological Sciences, Dublin Institute of Technology Kevin Street, Dublin, Ireland 2National Centre for Paediatric Gastroenterology, Hepatology and Nutrition, Our Lady’s Children’s Hospital, Crumlin, Dublin 12 3Academic Centre for Paediatric Research, School of Medicine and Medical Sciences, University College Dublin 4National Children’s Research Centre, Crumlin, Dublin 12


Home parenteral nutrition (HPN) is the intravenous administration of nutrients and fluids via a central venous catheter in the patient’s home. This is the primary maintenance therapy for children with chronic intestinal failure.


Internationally, outcomes have improved for children since home parenteral nutrition was first introduced. However, Irish paediatrics home parenteral nutrition outcome data is limited. The aim of the present study was to describe the longterm outcomes of the Irish paediatric home parenteral nutrition population and to analyse the influence of age at parenteral nutrition onset and aetiology of intestinal failure on these outcomes.


Data were extracted retrospectively from medical records. All children in Ireland commenced on home parenteral nutrition between the 1st January 2000 and the 28th February 2015 were included. Data were collected from the date of parenteral nutrition commencement in hospital until the end of the most recent year, death or until one year post home parenteral nutrition. Patient aetiologies were classified as either medical or surgical, parenteral nutrition commencement time as having begun before or after 6 months of age. Data was compiled and analysed the SPSS statistical package.


A total of 32 patients were enrolled on the HPN programme. Currently, 13 patients continue on home parenteral nutrition. The mortality rate was 28% (n = 9) and the weaning rate was 31% (n = 10). The incidence of central line sepsis was 2.3 per 1000 days of HPN. Parenteral nutrition associated liver disease was highest in surgical patients (9/11, 81%) who began parenteral nutrition <30 days old (p <0.03). Surgical patients who began parenteral nutrition <6 months were weaned from home parenteral nutrition quicker (8/10, 80%) than medical patients who began parenteral nutrition <6 months (2/10, 20%) (p <0.03). Surgical patients had a higher mean height z-score (p <0.004) and mean weight z-score (p < 0.01) in their first year on home parenteral nutrition than medical patients.


This is the first study to describe the outcomes of paediatric HPN in Ireland. A surgical diagnosis and a younger age at parenteral nutrition onset affect parenteral nutrition associated liver disease risk and weaning rate. A surgical diagnosis is also associated with normal growth on home parenteral nutrition. A medical diagnosis is associated with a longer duration of home parenteral nutrition and poorer growth outcomes.