ABSTRACT
When the GI tract is non-functional or absorption is poor due to structural and functional changes which result in malabsorption of macro and micronutrients, parenteral nutrition support can be lifesaving. When PN is required for several weeks, long-term or lifetime, it can be delivered at home and is called home parenteral nutrition (HPN). This chapter covers initiating, monitoring, and complications and reimbursement of HPN, primarily in adults as pediatric HPN is a specialized practice. Pediatric HPN management has its own complexities – including metabolic, growth facilitation, compatibilities of formula components and psychosocial that are beyond the scope of this chapter. Clinical decisions regarding patient need for HPN therapy must be made with consideration of reimbursement availability for the therapy. If a patient does not have coverage for HPN, other considerations must be made including placement in a long-term care facility or skilled nursing facility.
