Where comfort and nutrition meet: A case series of children with severe neurologic impairment receiving home parenteral nutrition at the end of life

Where comfort and nutrition meet: A case series of children with severe neurologic impairment receiving home parenteral nutrition at the end of life
Nutrition in Clinical Practice; by Dana Steien, Erin Alexander, Molissa Hager, Andrea Armellino, Megan Thorvilson; 9/25
Increasingly, home parenteral nutrition (HPN) ... is used for intractable feeding intolerance (IFI), which can occur near the end of life (EOL) in children with severe neurological impairment (SNI). [Four cases were retrospectively examined and we] found that the pediatric palliative care team (PPCT) was involved in all cases during HPN decision-making and planning. The pediatric nutrition support team (PNST) and PPCT collaborated to provide individualized, goal-directed care. All [patients] were enrolled in hospice while receiving HPN. HPN at EOL requires careful ethical consideration, particularly of autonomy because families often find comfort in providing nutrition.