Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure.

Pironi, Loris and Steiger, Ezra and Joly, Francisca and Wanten, Geert J A and Chambrier, Cecile and Aimasso, Umberto and Sasdelli, Anna Simona and Szczepanek, Kinga and Jukes, Amelia and Theilla, Miriam and Kunecki, Marek and Daniels, Joanne and Serlie, Mireille J and Cooper, Sheldon C and Poullenot, Florian and Rasmussen, Henrik Højgaard and Compher, Charlene W and Crivelli, Adriana and Hughes, Sarah-Jane and Santarpia, Lidia and Guglielmi, Francesco William and Rotovnik Kozjek, Nada and Ellegard, Lars and Schneider, Stéphane M and Matras, Przemysław and Forbes, Alastair and Wyer, Nicola and Zmarzly, Anna and Taus, Marina and O'Callaghan, Margie and Osland, Emma and Thibault, Ronan and Cuerda, Cristina and Jones, Lynn and Chapman, Brooke and Sahin, Peter and Virgili, Núria M and Lee, Andre Dong Won and Orlandoni, Paolo and Matysiak, Konrad and Di Caro, Simona and Doitchinova-Simeonova, Maryana and Masconale, Luisa and Spaggiari, Corrado and Garde, Carmen and Serralde-Zúñiga, Aurora E and Olveira, Gabriel and Krznaric, Zeljko and Petrina Jáuregui, Estrella and Zugasti Murillo, Ana and Suárez-Llanos, José P and Nardi, Elena and Van Gossum, André and Lal, Simon (2020) Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure. Gut. ISSN 1468-3288.

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Official URL: https://gut.bmj.com/content/early/2020/01/21/gutjn...

Abstract

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.

Item Type: Article
Subjects: QU Biochemistry
WD Diseases and disorders of systemic, metabolic or environmental origin
WI Digestive system. Gastroenterology
Divisions: Clinical Support > Immunology
Planned IP Care > Gastroentrology
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Depositing User: Mr Muneeb Liaquat
Date Deposited: 24 Jan 2020 14:59
Last Modified: 24 Jan 2020 14:59
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2793

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