Long term home parenteral nutrition using a subcutaneous venous access.

Home parenteral nutrition (HPN) utilising a subcutaneous venous access (SVA) infusion system (port-a-cath((R)) (PAC)), allows patients with a nonfunctioning bowel to lead a relatively normal life with full nutritional support. A patient with pseudo-obstruction of the bowel due to scleroderma was treated with HPN for 1192 consecutive days. During this time the patient underwent 6 catheter or port changes due to occlusion of the infusion system. The infusion regime was modified several times in an attempt to prevent occlusion. Infusing carbohydrate and protein daily, with a lipid infusion twice weekly increased the patency of the infusion system. In 2 other patients, rinsing the infusion system with 2ml of a 45% alcohol solution after use increased the patency of the infusion system further. This regime has now been in use for 924 consecutive days with no occlusions.