ABSTRACT Chronic intestinal failure (CIF) is a rare condition requiring home parenteral nutrition (HPN) for long-term survival. Since its introduction in Malaysia in 1994, HPN… Read More »Home Parenteral Nutrition: Malaysian Perspectives and a Localised Checklist
Patients who are unable to use their gastrointestinal system for feeding purposes are now usually started on parenteral nutrition. It is a therapeutic tool used in the clinical management of patients requiring special nutritional care both in the hospital, and at home (home parenteral nutrition). The idea of providing nutrients intravenously in humans was first realised when Sir Christopher Wren injected wine and ale in dogs way back in the middle of the 17th century. The historic experiment initiated further investigation and studies on this novel approach to nutrition. Better understanding of the metabolic and pharmacological properties of the macronutrients (protein, carbohydrates, and lipid), the micronutrients (trace elements, and vitamins), and the electrolytes have made it possible to administer parenteral nutrition safely to all types of patients where it is indicated. Continuous development and improvement in the pharmaceutical presentations of these nutrients have helped to minimise the metabolic problems seen in the early days of parenteral nutrition administration. Production of the single- or multilayered parenteral nutrition bags using materials which are inert and capable of reducing oxygen permeability such as the combination of ethylenevinylacetate-polyvinylidine chloride has ensured better stability of the parenteral nutrition admixture. The multicompartmental bag has provided a much more simpler and convenient way of initiating parenteral nutrition. The increase in knowledge, development and improvement in parenteral nutrition support has made it possible to provide parenteral nutrition support at home.