P1157 LONGTERM PARENTERAL NUTRITION OF CHILDREN -THE GERMAN EXPERIENCE

Abstract

Introduction: Longterm parenteral nutrition of children and adolescents is monitored in Germany since 2001. As the conditions requiring this type of nutritional care are rare, single pediatricians have little chance to get experienced. A prospective collaborative study has been started in order to improve the technique for the benefit of the children. Methods: Data are collected from 27 departments of pediatrics and pediatric surgery throughout Germany. Data are recorded safely in a data bank facilitating regular evaluation for growth, nutrient provision, catheter management and complications. Results: Children and adolscents grow under parenteral nutrition - more or less steadily along the -2SD-curve of reference data from healthy children. Nutrient provision shows little variability; the mostly changed nutrient is glucose (as more energy as more glucose). Although variance in catheter management is limited the frequency of infections is widely variabel; in most children the rate of infections is low. Median duration of a CVL is 14.6 months. More than 75% of the children have normal liver function. Conclusion: Longterm parenteral nutrition of children and adolescents in Germany is a safe technique providing the chance of near normal growth. Most children have the chance to reach enteral adaptation. Complications can be managed in most cases by prevention of infections and need-oriented nutrient supply. The costs in terms of finances and in terms of need for high-qualified care are high. Quality managfement should be considered when PN-programmes are implemented. The cooperation of the pediatricians caring for the patients is highly appreciated.