Successful long-term intravenous hyperalimentation in the hospital and at home.

Experience with long-term intravenous hyperalimentation in the hospital and at home in one patient over a 22-month period is reported. After multiple operative procedures the patient was left with only her stomach, duodenum, and 5 cm of the proximal part of the jejunum. During a 12-month period in the hospital, despite many life-threatening complications and with high-output intestinal fistulas, her weight increased from 40.7 kg (90 lb) to 70.1 kg (155 lb) on intravenous hyperalimentation therapy. During the past ten months, the patient has managed her intravenous feeding at home. A silicone elastomer catheter inserted into her superior vena cava through her facial vein has been used for the past ten months with no catheter sepsis. Although costly, home intravenous alimentation seems justifiable in selected patients because of the possible feasibility of bowel transplants in the near future.