RT Journal Article
SR Electronic
T1 Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 1787
OP 1795
DO 10.1136/gutjnl-2018-318172
VO 69
IS 10
A1 Loris Pironi
A1 Ezra Steiger
A1 Francisca Joly
A1 Geert J A Wanten
A1 Cecile Chambrier
A1 Umberto Aimasso
A1 Anna Simona Sasdelli
A1 Kinga Szczepanek
A1 Amelia Jukes
A1 Miriam Theilla
A1 Marek Kunecki
A1 Joanne Daniels
A1 Mireille J Serlie
A1 Sheldon C Cooper
A1 Florian Poullenot
A1 Henrik Højgaard Rasmussen
A1 Charlene W Compher
A1 Adriana Crivelli
A1 Sarah-Jane Hughes
A1 Lidia Santarpia
A1 Francesco William Guglielmi
A1 Nada Rotovnik Kozjek
A1 Lars Ellegard
A1 Stéphane M Schneider
A1 Przemysław Matras
A1 Alastair Forbes
A1 Nicola Wyer
A1 Anna Zmarzly
A1 Marina Taus
A1 Margie O'Callaghan
A1 Emma Osland
A1 Ronan Thibault
A1 Cristina Cuerda
A1 Lynn Jones
A1 Brooke Chapman
A1 Peter Sahin
A1 Núria M Virgili
A1 Andre Dong Won Lee
A1 Paolo Orlandoni
A1 Konrad Matysiak
A1 Simona Di Caro
A1 Maryana Doitchinova-Simeonova
A1 Luisa Masconale
A1 Corrado Spaggiari
A1 Carmen Garde
A1 Aurora E Serralde-Zúñiga
A1 Gabriel Olveira
A1 Zeljko Krznaric
A1 Estrella Petrina Jáuregui
A1 Ana Zugasti Murillo
A1 José P Suárez-Llanos
A1 Elena Nardi
A1 André Van Gossum
A1 Simon Lal
YR 2020
UL http://gut.bmj.com/content/69/10/1787.abstract
AB Background and aim No marker to categorise the severity of chronic intestinal failure (CIF) has been developed. A 1-year international survey was carried out to investigate whether the European Society for Clinical Nutrition and Metabolism clinical classification of CIF, based on the type and volume of the intravenous supplementation (IVS), could be an indicator of CIF severity.Methods At baseline, participating home parenteral nutrition (HPN) centres enrolled all adults with ongoing CIF due to non-malignant disease; demographic data, body mass index, CIF mechanism, underlying disease, HPN duration and IVS category were recorded for each patient. The type of IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorised as <1, 1–2, 2–3 and >3 L/day. The severity of CIF was determined by patient outcome (still on HPN, weaned from HPN, deceased) and the occurrence of major HPN/CIF-related complications: intestinal failure-associated liver disease (IFALD), catheter-related venous thrombosis and catheter-related bloodstream infection (CRBSI).Results Fifty-one HPN centres included 2194 patients. The analysis showed that both IVS type and volume were independently associated with the odds of weaning from HPN (significantly higher for PN <1 L/day than for FE and all PN >1 L/day), patients’ death (lower for FE, p=0.079), presence of IFALD cholestasis/liver failure and occurrence of CRBSI (significantly higher for PN 2–3 and PN >3 L/day).Conclusions The type and volume of IVS required by patients with CIF could be indicators to categorise the severity of CIF in both clinical practice and research protocols.