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Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure.
Gut 2020Gut

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.

Authors+Show Affiliations

Medical and Surgical Sciences, University of Bologna, Bologna, Italy loris.pironi@unibo.it.Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA.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.Flinders Medical Centre, Bedford Park, Adelaide, Australia.Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia.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.Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.Nutrition and Dietetics, Austin Health, Heidelberg, Victoria, Australia.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.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31964752

Citation

Pironi, Loris, et al. "Intravenous Supplementation Type and Volume Are Associated With 1-year Outcome and Major Complications in Patients With Chronic Intestinal Failure." Gut, 2020.
Pironi L, Steiger E, Joly F, et al. Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure. Gut. 2020.
Pironi, L., Steiger, E., Joly, F., Wanten, G. J. A., Chambrier, C., Aimasso, U., ... Lal, S. (2020). Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure. Gut, doi:10.1136/gutjnl-2018-318172.
Pironi L, et al. Intravenous Supplementation Type and Volume Are Associated With 1-year Outcome and Major Complications in Patients With Chronic Intestinal Failure. Gut. 2020 Jan 21; PubMed PMID: 31964752.
* Article titles in AMA citation format should be in sentence-case
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 - Petrina Jáuregui,Estrella, AU - Zugasti Murillo,Ana, AU - Suárez-Llanos,José P, AU - Nardi,Elena, AU - Van Gossum,André, AU - Lal,Simon, Y1 - 2020/01/21/ PY - 2018/12/24/received PY - 2019/12/23/revised PY - 2020/01/07/accepted PY - 2020/1/23/entrez KW - intestinal failure KW - liver failure KW - motility disorders KW - parenteral nutrition KW - short bowel syndrome JF - Gut JO - Gut 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. SN - 1468-3288 UR - https://www.unboundmedicine.com/medline/citation/31964752/Intravenous_supplementation_type_and_volume_are_associated_with_1-year_outcome_and_major_complications_in_patients_with_chronic_intestinal_failure L2 - http://gut.bmj.com/cgi/pmidlookup?view=long&amp;pmid=31964752 DB - PRIME DP - Unbound Medicine ER -