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Vol. 49. Núm. 7.
Páginas 227-231 (agosto 2002)
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Vol. 49. Núm. 7.
Páginas 227-231 (agosto 2002)
Acceso a texto completo
Reflexiones sobre la nutrición artificial domiciliaria
Reflections On Home Nutrition Therapy
Visitas
4732
M. Planas
Autor para correspondencia
mplanas@hg.vhebron.es

Correspondencia: Dra. M. Planas. Hospital Vall d’ Hebron. Unidad de Soporte Nutricional. P.° Vall d’ Hebron, 119-129. 08035 Barcelona.
, R. Burgos
Unitat de Suport Nutricional. Hospital Universitari Vall d'Hebron. Barcelona
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Información del artículo

La nutrición artificial domiciliaria (NAD) o administración de nutrientes a través de la vía digestiva o intravenosa, como los demás tratamientos administrados a domicilio, están en fase de crecimiento por las implicaciones sociosanitarias que comportan, pero su éxito requiere el control por parte de un equipo de soporte nutritivo multidisciplinario y la aplicación sistemática de un plan estratégico de actuación y seguimiento que englobe desde la correcta selección del paciente al proceso de transferencia del hospital a domicilio, el adiestramiento en la técnica del paciente, familiar o cuidador, las consideraciones de financiación, el plan de actuación y cuidados, etc., todo ello encaminado a conseguir unos objetivos previamente definidos que se revisarán periódicamente suspendiéndose cuando ya no aporten ningún beneficio al paciente. Si bien la incidencia de NAD no está perfectamente conocida por depender de la existencia o no de registros voluntarios, su implementación en nuestro país está en niveles muy inferiores a otros países europeos comparables (Italia, Francia). Las principales indicaciones de esta modalidad terapéutica administrada por vía enteral son los trastornos de la deglución de cualquier etiología, mientras que el uso de la administración parenteral predomina en pacientes con síndrome de intestino corto o con obstrucción intestinal. A pesar de los motivos de discusión que comporta administrar este tratamiento a pacientes terminales o a neoplásicos no subsidiarios de tratamiento curativo, su uso debe ser discutido de forma individual después de un buen conocimiento por parte del paciente y la familia de las ventajas e inconvenientes de cada tratamiento.

Palabras clave:
Nutrición artificial domiciliaria
Nutrición enteral domiciliaria
Nutrición parenteral domiciliaria

Home nutrition therapy (HNT), or the provision of nutrients and any necessary adjunctive therapeutic agents to patients through administration into the stomach or intestine or through intravenous infusion, is a relatively new therapy which, like all other treatments administered in the nonhospital setting, is increasing every year due to social, medical and economic factors. However, the success of this therapy requires the involvement of a multidisciplinary nutritional support team and the development and application of guidelines that include well-defined selection criteria, the transfer from the hospital to the home, the educational strategy, the financial implications, and the treatment plan and implementation standards. All these elements should be directed to obtain previously defined aims that should be periodically reviewed and the treatment should be withdrawn when it is not beneficial to the patient. Although the extent of use of this therapy is not fully known because data are gathered in voluntary registers, its implementation in Spain is lower than that in similar European countries (Italy and France). The major indications of home enteral nutrition are swallowing disorders of various etiology, while the major indications for home parenteral nutrition are severe short bowel syndrome and bowel obstruction. Although controversy surrounds nutritional support in inpatients with severe disabilities or terminal cancer, the use of this therapy should be analyzed individually and patients/relatives should receive realistic information about its advantages and disadvantages.

Key words:
Home nutrition therapy
Home enteral nutrition
Home parenteral nutrition
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Copyright © 2002. Sociedad Española de Endocrinología y Nutrición
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