TY - JOUR
T1 - Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure
AU - Pironi, Loris
AU - Steiger, Ezra
AU - Joly, Francisca
AU - Wanten, Geert J.A.
AU - Chambrier, Cecile
AU - Aimasso, Umberto
AU - Sasdelli, Anna Simona
AU - Szczepanek, Kinga
AU - Jukes, Amelia
AU - Theilla, Miriam
AU - Kunecki, Marek
AU - Daniels, Joanne
AU - Serlie, Mireille J.
AU - Cooper, Sheldon C.
AU - Poullenot, Florian
AU - Rasmussen, Henrik Højgaard
AU - Compher, Charlene W.
AU - Crivelli, Adriana
AU - Hughes, Sarah Jane
AU - Santarpia, Lidia
AU - Guglielmi, Francesco William
AU - Rotovnik Kozjek, Nada
AU - Ellegard, Lars
AU - Schneider, Stéphane M.
AU - Matras, Przemysław
AU - Forbes, Alastair
AU - Wyer, Nicola
AU - Zmarzly, Anna
AU - Taus, Marina
AU - O'Callaghan, Margie
AU - Osland, Emma
AU - Thibault, Ronan
AU - Cuerda, Cristina
AU - Jones, Lynn
AU - Chapman, Brooke
AU - Sahin, Peter
AU - Virgili, Núria M.
AU - Lee, Andre Dong Won
AU - Orlandoni, Paolo
AU - Matysiak, Konrad
AU - Di Caro, Simona
AU - Doitchinova-Simeonova, Maryana
AU - Masconale, Luisa
AU - Spaggiari, Corrado
AU - Garde, Carmen
AU - Serralde-Zúñiga, Aurora E.
AU - Olveira, Gabriel
AU - Krznaric, Zeljko
AU - Jáuregui, Estrella Petrina
AU - Murillo, Ana Zugasti
AU - Suárez-Llanos, José P.
AU - Nardi, Elena
AU - Van Gossum, André
AU - Lal, Simon
N1 - Publisher Copyright:
© 2020 BMJ Publishing Group. All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - 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.
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.
KW - intestinal failure
KW - liver failure
KW - motility disorders
KW - parenteral nutrition
KW - short bowel syndrome
UR - http://www.scopus.com/inward/record.url?scp=85078478975&partnerID=8YFLogxK
U2 - 10.1136/gutjnl-2018-318172
DO - 10.1136/gutjnl-2018-318172
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C2 - 31964752
AN - SCOPUS:85078478975
SN - 0017-5749
VL - 69
SP - 1787
EP - 1795
JO - Gut
JF - Gut
IS - 10
ER -