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You are consulted as the HPN expert by the inpatient cardiology team to facilitate discharge for a 3 year-old female with a history of heart transplant for hypoplastic left heart syndrome was admitted for new onset 3-week history of vomiting, diarrhea and weight loss. Diagnostic laboratory and...

A 25 year-old patient with a Port-a-Cath implanted in the right chest complains of sudden onset severe neck pain and headaches with flushing central line and PN infusions. Labs and exam normal, including afebrile. Previous X-ray shows central line tip in at the cavo-atrial junction. Today, chest X...

Population Home parenteral nutrition is a life-sustaining therapy provided to ~40,000 people in the United States. Delegge MH. Demographics of home parenteral nutrition. JPEN J Parenter Enteral Nutr. 2002 Sep-Oct;26(5 Suppl):S60-2. Review. PubMed PMID: 12216724. Total annual care In 2008...

Pathophysiology: Mutations EPCAM Disordered fixation protein expression along the basolateral membrane of intestinal epithelium (especially in crypts), which leads to the consequence of tufts along villi. Salomon J, Espinosa-Parrilla Y, Goulet O, Al-Qabandi W, Guigue P, Canioni D, Bruneau J...

Parent of a 1 year-old female on home parenteral nutrition secondary to short bowel syndrome (necrotizing enterocolitis) calls with a 2-day history of fever 101 degrees Fahrenheit (38.3 degrees Celsius). There are no other clinical complaints besides from teething. What is the next step? A...

5 year-old male with long-term HPN dependence secondary to short bowel syndrome is seen for routine follow-up. Enteral tolerance is currently maximized. PN currently providing energy 45 kcal/kg/day, protein 1.3 gram/kg/day, IV soybean lipids 1 gram/kg/day, glucose infusion rate 10 mg/kg/minute...