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Title: Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure.
Austin Authors: Pironi, Loris;Steiger, Ezra;Joly, Francisca;Wanten, Geert J A;Chambrier, Cecile;Aimasso, Umberto;Sasdelli, Anna Simona;Szczepanek, Kinga;Jukes, Amelia;Theilla, Miriam;Kunecki, Marek;Daniels, Joanne;Serlie, Mireille J;Cooper, Sheldon C;Poullenot, Florian;Rasmussen, Henrik Højgaard;Compher, Charlene W;Crivelli, Adriana;Hughes, Sarah-Jane;Santarpia, Lidia;Guglielmi, Francesco William;Rotovnik Kozjek, Nada;Ellegard, Lars;Schneider, Stéphane M;Matras, Przemysław;Forbes, Alastair;Wyer, Nicola;Zmarzly, Anna;Taus, Marina;O'Callaghan, Margie;Osland, Emma;Thibault, Ronan;Cuerda, Cristina;Jones, Lynn;Chapman, Brooke ;Sahin, Peter;Virgili, Núria M;Lee, Andre Dong Won;Orlandoni, Paolo;Matysiak, Konrad;Di Caro, Simona;Doitchinova-Simeonova, Maryana;Masconale, Luisa;Spaggiari, Corrado;Garde, Carmen;Serralde-Zúñiga, Aurora E;Olveira, Gabriel;Krznaric, Zeljko;Petrina Jáuregui, Estrella;Zugasti Murillo, Ana;Suárez-Llanos, José P;Nardi, Elena;Van Gossum, André;Lal, Simon
Affiliation: Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
Flinders Medical Centre, Bedford Park, Adelaide, Australia
Department of Nutrition and Dietetics, Austin Health, Heidelberg, Victoria, Australia
Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia
Service de Gastroentérologie et d'Assistance nutritive, Hôpital Beaujon, Assistance Publique - Hopitaux de Paris, University of Paris, Clichy, France
Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
Centre Hospitalier Universitaire de Lyon, Lyon, Rhône-Alpes, France
Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino, Torino, Piemonte, Italy
Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Stanley Dudrick's Memorial Hospital, Skawina, Poland
University Hospital of Wales, Cardiff, Cardiff, UK
Nursing Department, Steyer School of Health Professions, Sackler School of Medicine, Tel Aviv, Israel
Clinical Nutrition Department, M Pirogow Hospital, Lodz, Poland
Nottingham University Hospital NHS Trust, Nottingham, UK
Endocrinology and Metabolism, Academic Medical Center, Amsterdam, The Netherlands
University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK
Hôpital Haut-Lévêque, Service d'hépato-gastroentérologie, CHU Bordeaux, Pessac, France
Center for Nutrition and Bowel Disease, Department of Medical Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Fundacion Favaloro Hospital Universitario, Buenos Aires, Federal District, Argentina
Belfast Health and Social Care Trust, Belfast, Belfast, UK
Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II, Napoli, Campania, Italy
Gastroenterology and Artificial Nutrition, Hospital Mons. Dimiccoli, Barletta, Trani, Italy
Institute of Oncology, Ljubljana, Slovenia
Sahlgrenska Universitetssjukhuset, Goteborg, Sweden
Centre Hospitalier Universitaire de Nice, Nice, Provence-Alpes-Côte d'Azur, France
Uniwersytet Medyczny w Lublinie, Lublin, Lubelskie, Poland
Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK
University Hospital Coventry, Coventry, Coventry, UK
J Gromkowski City Hospital, Wroclaw, Poland
Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Umberto I G M Lancisi G Salesi, Ancona, Marche, Italy
Centre de référence Maladies Rares Digestives, Unité de Nutrition, CHU Rennes, INRAE, INSERM, Universite de Rennes, Nutrition Metabolisms and Cancer institute, NuMeCan, Rennes, Bretagne, France
Hospital General Universitario Gregorio Maranon, Madrid, Madrid, Spain
St Imre Hospital, Budapest, Hungary
Unitat de Nutrició i Dietètica, Hospital Universitari Bellvitge, L'Hospitalet Llobregat, Barcelona, Spain
Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Clinical Nutrition, IRCCS-INRCA, Ancona, Marche, Italy
Centre for Intestinal Failure, Uniwersytet Medyczny imienia Karola Marcinkowskiego w Poznaniu, Poznan, Poland
Gastroenterology, UCLH, London, UK
Bulgarian Executive Agency of Transplantation, Sofia, Bulgaria
Unita' Locale Socio-Sanitaria N° 22, Bussolengo, Verona, Italy
Azienda Unita Sanitaria Locale di Parma, Parma, Emilia-Romagna, Italy
Hospital Universitario de Donostia, San Sebastian, País Vasco, Spain
Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, DF, Mexico
Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain..
University Hospital Centre Zagreb, Zagreb, Croatia
Complejo Hospitalario de Navarra, Pamplona, Spain
Hospital Virgen del Camino, Pamplona, Navarra, Spain
Hospital Universitario Nuestra Senora de la Candelaria, Santa Cruz de Tenerife, Canarias, Spain
Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
Gastroenterology and Intestinal Failure Unit, Salford Royal Foundation Trust, University of Manchester, Manchester, UK
Issue Date: 21-Jan-2020
Date: 2020-01-21
Publication information: Gut 2020-01-21
Abstract: 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. 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). 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). 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.
DOI: 10.1136/gutjnl-2018-318172
ORCID: 0000-0002-1773-8330
Journal: Gut
PubMed URL: 31964752
Type: Journal Article
Subjects: intestinal failure
liver failure
motility disorders
parenteral nutrition
short bowel syndrome
Appears in Collections:Journal articles

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