Nutrición parenteral domiciliaria en pacientes con obstrucción intestinal maligna. Consideraciones éticas.

Background: patients with cancer are one of the main group of patients on home parenteral nutrition (HPN). Patients with malignant bowel obstruction (MBO) represent a challenging group when considering HPN. At the Ethics Working Group of SENPE ethical considerations on this subject were reviewed and...

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Autores: Moreno Villares JM, Virgili-Casas MN, Ashbaugh Enguídanos R, Wanden-Berghe C, Cantón Blanco A, Álvarez Hernández J, Bretón I, Del Olmo D, Ferrero López I, Lozano Fuster FM, Molina Soria JB
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2024
País:España
Recursos:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositório:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p16076
Acesso em linha:https://fisabio.portalinvestigacion.com/publicaciones/16076
Access Level:Acceso aberto
Palavra-chave:Obstrucción intestinal maligna. Nutrición parenteral domiciliaria. Cáncer avanzado. Futilidad. Cuidados paliativos.
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spelling Nutrición parenteral domiciliaria en pacientes con obstrucción intestinal maligna. Consideraciones éticas.Moreno Villares JMVirgili-Casas MNAshbaugh Enguídanos RWanden-Berghe CCantón Blanco AÁlvarez Hernández JBretón IDel Olmo DFerrero López ILozano Fuster FMMolina Soria JBObstrucción intestinal maligna. Nutrición parenteral domiciliaria. Cáncer avanzado. Futilidad. Cuidados paliativos.Background: patients with cancer are one of the main group of patients on home parenteral nutrition (HPN). Patients with malignant bowel obstruction (MBO) represent a challenging group when considering HPN. At the Ethics Working Group of SENPE ethical considerations on this subject were reviewed and a guidelines proposal was made. Methods: a literature search was done and a full set of questions arose: When, if ever, is HPN indicated for patients with MBO? How should the training program be? When withdrawal of HPN should be considered? Other questions should be also taken into consideration. May any Oncologist send home a patient with HPN? The educational program could be shortened? When considering to withdraw parenteral nutrition? Results: HPN in MBO has better outcomes when patients have a good functional status (Karnofsky = 50 or ECOG = 2), expected survival > 2-3 months, and low inflammatory markers. Very few data have been reported on quality of life, but HPN allows a valuable time at home albeit with a considerable burden for both patients and their families. Proposal: once a patient is considered for HPN, there is a need for a deep talk on the benefits, complications and risks. In this initial talk, when HNP should be stopped needs to be included. The palliative care team with the help of the nutrition support team should follow the patient, whose clinical status must be assessed regularly. HPN should be withdrawn when no additional benefits are achieved. Conclusion: HPN may be considered an option in patients with MBO when they have a fair or good functional status and a desire to spend their last days at home.ARAN EDICIONES, S L2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/16076Nutricion HospitalariaISSN: 02121611ISSNe: 16995198reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Españolinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p160762026-06-11T12:45:17Z
dc.title.none.fl_str_mv Nutrición parenteral domiciliaria en pacientes con obstrucción intestinal maligna. Consideraciones éticas.
title Nutrición parenteral domiciliaria en pacientes con obstrucción intestinal maligna. Consideraciones éticas.
spellingShingle Nutrición parenteral domiciliaria en pacientes con obstrucción intestinal maligna. Consideraciones éticas.
Moreno Villares JM
Obstrucción intestinal maligna. Nutrición parenteral domiciliaria. Cáncer avanzado. Futilidad. Cuidados paliativos.
title_short Nutrición parenteral domiciliaria en pacientes con obstrucción intestinal maligna. Consideraciones éticas.
title_full Nutrición parenteral domiciliaria en pacientes con obstrucción intestinal maligna. Consideraciones éticas.
title_fullStr Nutrición parenteral domiciliaria en pacientes con obstrucción intestinal maligna. Consideraciones éticas.
title_full_unstemmed Nutrición parenteral domiciliaria en pacientes con obstrucción intestinal maligna. Consideraciones éticas.
title_sort Nutrición parenteral domiciliaria en pacientes con obstrucción intestinal maligna. Consideraciones éticas.
dc.creator.none.fl_str_mv Moreno Villares JM
Virgili-Casas MN
Ashbaugh Enguídanos R
Wanden-Berghe C
Cantón Blanco A
Álvarez Hernández J
Bretón I
Del Olmo D
Ferrero López I
Lozano Fuster FM
Molina Soria JB
author Moreno Villares JM
author_facet Moreno Villares JM
Virgili-Casas MN
Ashbaugh Enguídanos R
Wanden-Berghe C
Cantón Blanco A
Álvarez Hernández J
Bretón I
Del Olmo D
Ferrero López I
Lozano Fuster FM
Molina Soria JB
author_role author
author2 Virgili-Casas MN
Ashbaugh Enguídanos R
Wanden-Berghe C
Cantón Blanco A
Álvarez Hernández J
Bretón I
Del Olmo D
Ferrero López I
Lozano Fuster FM
Molina Soria JB
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Obstrucción intestinal maligna. Nutrición parenteral domiciliaria. Cáncer avanzado. Futilidad. Cuidados paliativos.
topic Obstrucción intestinal maligna. Nutrición parenteral domiciliaria. Cáncer avanzado. Futilidad. Cuidados paliativos.
description Background: patients with cancer are one of the main group of patients on home parenteral nutrition (HPN). Patients with malignant bowel obstruction (MBO) represent a challenging group when considering HPN. At the Ethics Working Group of SENPE ethical considerations on this subject were reviewed and a guidelines proposal was made. Methods: a literature search was done and a full set of questions arose: When, if ever, is HPN indicated for patients with MBO? How should the training program be? When withdrawal of HPN should be considered? Other questions should be also taken into consideration. May any Oncologist send home a patient with HPN? The educational program could be shortened? When considering to withdraw parenteral nutrition? Results: HPN in MBO has better outcomes when patients have a good functional status (Karnofsky = 50 or ECOG = 2), expected survival > 2-3 months, and low inflammatory markers. Very few data have been reported on quality of life, but HPN allows a valuable time at home albeit with a considerable burden for both patients and their families. Proposal: once a patient is considered for HPN, there is a need for a deep talk on the benefits, complications and risks. In this initial talk, when HNP should be stopped needs to be included. The palliative care team with the help of the nutrition support team should follow the patient, whose clinical status must be assessed regularly. HPN should be withdrawn when no additional benefits are achieved. Conclusion: HPN may be considered an option in patients with MBO when they have a fair or good functional status and a desire to spend their last days at home.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/16076
url https://fisabio.portalinvestigacion.com/publicaciones/16076
dc.language.none.fl_str_mv Español
language_invalid_str_mv Español
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ARAN EDICIONES, S L
publisher.none.fl_str_mv ARAN EDICIONES, S L
dc.source.none.fl_str_mv Nutricion Hospitalaria
ISSN: 02121611
ISSNe: 16995198
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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