BC Home Parenteral Nutrition (HPN) Program
The BC Home Parenteral Nutrition (HPN) Program provides support to patients in British Columbia and the Yukon who have specialized nutrition requirements due to gastrointestinal tract (“gut”) problems.
Our patients are not able to break down and absorb many of the nutrients found in a normal diet. Instead, our patients have to consume total or supplemental nutrition and/or hydration intravenously (IV).
The BC HPN Program is designed to support individuals who have intestinal failure and require parenteral nutrition, but who are otherwise able to live at home. The BC HPN Program strives to improve the quality of life of the patients it serves. Parenteral nutrition is a life-saving therapy for all of our patients. Without it, most of our patients would not have the ability to carry out their independent activities of daily living and many would not be alive.
The adult component of the BC HPN Program is based out of St. Paul’s Hospital and the pediatric component of the BC HPN Program is based out of BC Children’s Hospital. Both the adult and pediatric components share a similar philosophy and instruct patients and/or their caregivers how to provide parenteral nutrition solutions intravenously.
Also known as “consumers,” our adult and pediatric patients are provided with ongoing medical, nutritional and nursing follow-up of HPN to help them stay healthy and reduce complications. The focus of the Program is to support consumers to live in their home and receive ongoing care in their community.
Please note that the BC HPN Program has very specific application criteria. Refer to the Adult Application for more information.
What is Parenteral Nutrition?
Parenteral nutrition (PN) is a medical and nutritional therapy that is usually administered in a hospital for a short time. You may also hear people refer to it as Total Parenteral Nutrition or TPN.
When a person lacks a functioning gut, or gastrointestinal tract, they may not be able to breakdown and absorb the nutrients in the foods that they eat. PN gives people the nutrients and fluid they need to stay healthy. For many people, this treatment can save their life and allow them to return home and even to work. Many home parenteral nutrition (HPN) consumers experience an improved quality of life due to an improved nutrition status.
Parenteral nutrition gives the nutrients needed in a solution that is designed specially for each person. The solution is infused into the body through the person’s bloodstream. This means that HPN consumers are fed through their bloodstream rather than their stomach, unless they are still taking some food or fluids by mouth.
The solution goes into the bloodstream through a central venous catheter (often called a CVC). A CVC is a soft flexible tube called a catheter that is inserted through a patient’s skin and goes into the main vein leading into the heart. A special pump is used to push the solution through the CVC into the bloodstream. It is called an infusion pump.
The PN solution contains all the nutrients a person needs and would normally get in their food. The usual components of a PN solution are protein, carbohydrates, fat, electrolytes, vitamins, minerals and fluid.
What is Home Parenteral Nutrition (HPN)?
In BC, PN is always initiated in a hospital setting, usually while a patient is unwell and unable to eat or drink adequately. While many patients recover from their illness to allow them to be discharged from hospital without requiring further treatment, some patients still require nutrition support after discharge. For patients who require PN at home, and they and/or a caregiver is able to learn how to provide HPN, the BC HPN Program can help transition a patient from hospital to home. The BC HPN Program supports a HPN consumer in their home.
Who Might Need HPN?
There are a number of medical conditions which prevent individuals from being adequately nourished with a regular diet. Most of the patients in the BC HPN Program have had some or most of their small bowel removed during surgeries and are unable to absorb enough nutrients. Other patients have bowel obstructions which prevent them from eating and/or drinking enough.
The age of patients requiring HPN treatment crosses the spectrum from infancy to old age. The majority of patients in the BC HPN Program are between 45 and 60 years of age, although some of our HPN consumers have been in their 70s and 80s!
HPN is a good option for those people who will be on PN for a long time (more than 3 months) and are able to perform the procedures themselves. HPN is not an option for those who are only on PN for a short time (less than 3 months) or those who need daily care for their medical problems. The length of time patients stay on the program varies from a few months to life. Most HPN consumers are on it for 5 to 8 years. The longest served HPN consumer in BC has been on HPN for over 30 years!
Visit the Oley Foundation website for more information about HPN.
