Clinical Nutrition 42 (2023)411-430Contents lists available at ScienceDirectCLINICALNUTRITIONClinical NutritionELSEVIERjournal homepage:http://www.elsevier.com/locate/cInuESPEN GuidelineESPEN practical guideline:Home parenteral nutritionLoris Pironi.b,Kurt Boeykens,Federico Bozzetti,Francisca Joly Stanislaw KlekSimon Lal Marek Lichota Stefan Muihlebach',Andre Van Gossum',Geert Wanten,Carolyn Wheatley Stephan C.Bischoff mUniversity of Bologna,Department of Medical and Surgical Sciences,ItalyIRCCS AOUBO,Centre for Chronic Intestinal Failure-Cinical Nutrition and Metabolism Unit,ItalyVitaz Hospital Nutrition Support Team,Sint-Niklaas,BelgiumFaculty of Medicine,University of Miln,ItalyBeaujon Hospital APHP University of Paris VIl.Clichy.FranceSurgical Oncology Cinic,The Maria Sklodowska-Curie National Cancer Institute,Krakow,PolandSalford Royal NHS Foundation Trust,Salford,UKIntestinal Failure Patients Association "Appetite for Life"Cracow.PolandDivision of Cinical Pharmacy and Epidemiology and Hospital Pharmacy.University of Basel Basel.SwitzerlandHopital Erasme and Institut Bordet,Brussels,BelgiumIntestinal Failure Unit,Radboud University Medical Centre,Nijmegen,the NetherandsSupport and Advocacy Group for People on Home Artijficial Nutrition (PINNT)UKm University of Hohenheim,Institute of Nutritional Medicine,Stuttgart,GermanyARTICLE INF OSUM MARYArticle history:This guideline will inform physicians,nurses,dieticans,pharmacists,caregivers and other homeReceived 29 November 2022parenteral nutrition (HPN)providers,as well as healthcare administrators and policy makers,aboutAccepted 5 December 2022appropriate and safe HPN provision.This guideline will also inform patients requiring HPN.The guidelineis based on previous published guidelines and provides an update of current evidence and expertKewordsopinion:it consists of 71 recommendations that address the indications for HPN,central venous accessCentral venous access devicedevice (CVAD)and infusion pump,infusion catheter and CVAD site care,nutritional admixtures,programHome parenteral nutritionIntestinal failuremonitoring and management.Meta-analyses,systematic reviews and single clinical trials based onMultidisciplinary teamclinical questions were searched according to the PICO format.The evidence was evaluated and used toParenteral nutrition admixturedevelop clinical recommendations implementing Scottish Intercollegiate Guidelines Network method-Patient trainingology.The guideline was commissioned and financially supported by ESPEN and members of theguideline group were selected by ESPEN.2023 European Society for Clinical Nutrition and Metabolism.Published by Elsevier Ltd.All rightsreserved.1.Introductionas supplemental (partial or complementary)PN,where nutrition isalso provided via the oral or enteral route.PN can be administeredParenteral nutrition (PN)is categorized as total (or exclusive)either in,or outside the hospital setting;the latter defined as homePN,where it meets the patient's nutrit
