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Guglielmi FW, Diamanti A, Gandullia P, Aimasso U, Arrigo S, Capriati T, Elia D, Guidetti M, Lezo A, Madeo A, Mazzuoli S, Merlo FD, Regano N, Sasdelli AS, Pironi L, De Francesco A. Non-interventional, 5-year retrospective data of home parenteral nutrition in patients with benign chronic intestinal failure: Analysis of an Italian nurse registry (SERECARE II). Nutrition 2024; 120:112257. [PMID: 38335907 DOI: 10.1016/j.nut.2023.112257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/17/2023] [Accepted: 10/01/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVE This study is an assessment of home parenteral nutrition service performance and safety and efficacy outcomes in patients with benign chronic intestinal failure. METHODS This is a retrospective, non-interventional, and multicenter study. Data were collected by trained nurses and recorded in a dedicated registry (SERECARE). RESULTS From January 1, 2013 to June 30, 2018, data from a total of 683 patients with benign chronic intestinal failure were entered in the registry. Patients included 208 pediatric (53.8% male; median age = 4.0 y) and 475 adult (47.6% male; median age = 59.0 y) participants. On average, patients were visited 5.4 ± 4.5 times and received 1.4 ± 0.8 training sessions. Retraining was not common and mostly due to change of therapy or change of caregiver. Of 939 complications, 40.9% were related to the central venous catheter and were mostly infectious (n = 182) and mechanical (n = 187). The rate of infectious and mechanical complications per 1000 catheter days decreased over 5 y (0.30-0.15 and 0.33 -0.19, respectively). The rate of complications per 1000 catheter days and the mean complications per patient were higher in pediatric than in adult patients. The hospitalization rate was 1.01 per patient throughout the study period. These data were similar to those registered in a previous study period (2002-2011) (n = 1.53 per patient). Changes over time in the efficacy variables were mostly small and non-significant. CONCLUSIONS This study confirms the importance of setting up and maintaining structured registries to monitor and improve home parenteral nutrition care. Safety outcomes have improved over the years, most likely due to the underlying efficient nursing service.
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Affiliation(s)
| | | | | | - Umberto Aimasso
- A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | | | | | - Antonella Lezo
- Ospedale Infantile Regina Margherita, A.O.U. Città della Salute e della Scienzadi Torino, Turin, Italy
| | | | | | | | - Nunzia Regano
- Ospedale Monsignor Raffaele Dimiccoli, Barletta, Italy
| | | | - Loris Pironi
- Centre for Chronic Intestinal Failure, IRCCS AOUBO, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Merlo FD, Aimasso U, Ossola M, Ippolito M, Cravero L, Ponzo V, Bo S. Effects of Treatment with Liraglutide Early after Surgical Intervention on Clinical Outcomes in Patients with Short Bowel Syndrome: A Pilot Observational "Real-Life" Study. Nutrients 2023; 15:2740. [PMID: 37375644 DOI: 10.3390/nu15122740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/13/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Liraglutide, a glucagon-like peptide-1 agonist, has been shown to have beneficial effects on fecal output in short bowel syndrome (SBS) by small human studies. Its potential effects early after gut resection are not known. In this pilot observational study, we described the 1- and 6-month liraglutide effects in 19 adult patients with a new SBS diagnosis within 1 month after surgical resection. Stomal/fecal and urinary outcomes, serum/urinary electrolytes, and body composition were assessed. Both within-group differences and between-group comparisons with 20 SBS patients refusing liraglutide treatment were evaluated. The main liraglutide-related side effect was mild nausea, except in one patient, who experienced severe nausea/vomiting. The median ostomy/fecal output was significantly reduced by -550 mL/day after 6 months of treatment (vs. -200 mL/day in untreated, p = 0.04). The number of patients reaching a ≥20% output reduction was 10/19 (52.6%) treated vs. 3/20 (15.0%) untreated patients (p = 0.013) at 1 month and 12/19 (63.2%) vs. 6/20 (30.0%) (p = 0.038) at 6 months, respectively. Participants with a clinically relevant output reduction at 6 months had a significantly lower baseline weight and BMI. Energy parenteral supply significantly decreased, while infused volumes, oral energy, and fluid intakes slightly decreased, though not significantly. This pilot study supports liraglutide benefits in ostomy/fecal output early after surgical gut resection in SBS patients, particularly in those with lower baseline weight values.
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Affiliation(s)
- Fabio Dario Merlo
- Dietetic and Clinical Nutrition Unit, Città della Salute e della Scienza Hospital, C.so Bramante 88, 10126 Torino, Italy
| | - Umberto Aimasso
- Dietetic and Clinical Nutrition Unit, Città della Salute e della Scienza Hospital, C.so Bramante 88, 10126 Torino, Italy
| | - Marta Ossola
- Dietetic and Clinical Nutrition Unit, Città della Salute e della Scienza Hospital, C.so Bramante 88, 10126 Torino, Italy
| | - Mirko Ippolito
- Dietetic and Clinical Nutrition Unit, Città della Salute e della Scienza Hospital, C.so Bramante 88, 10126 Torino, Italy
| | - Leila Cravero
- Dietetic and Clinical Nutrition Unit, Città della Salute e della Scienza Hospital, C.so Bramante 88, 10126 Torino, Italy
| | - Valentina Ponzo
- Department of Medical Science, University of Torino, C.so Dogliotti 14, 10126 Torino, Italy
| | - Simona Bo
- Dietetic and Clinical Nutrition Unit, Città della Salute e della Scienza Hospital, C.so Bramante 88, 10126 Torino, Italy
- Department of Medical Science, University of Torino, C.so Dogliotti 14, 10126 Torino, Italy
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Pira C, Aimasso U, Ippolito M, Merlo F, Ossola M, Chiarotto A, Anrò M. Use Of Teduglutide In The Treatment Of Chronic Intestinal Failure Associated With Short Bowel Syndrome In Adults: Real-Life Experience Of The Iicb Reference Centre Of The A.O.U. CittÀ Della Salute E Della Scienza Of Turin. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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D'Eusebio C, Merlo FD, Ossola M, Bioletto F, Ippolito M, Locatelli M, De Francesco A, Anrò M, Romagnoli R, Strignano P, Bo S, Aimasso U. Mortality and parenteral nutrition weaning in patients with chronic intestinal failure on home parenteral nutrition: A 30-year retrospective cohort study. Nutrition 2023; 107:111915. [PMID: 36566610 DOI: 10.1016/j.nut.2022.111915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/06/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Home parenteral nutrition (HPN) is the standard treatment for patients with chronic intestinal failure (CIF). Mortality and weaning rates of these patients differ widely among cohorts; however, these outcomes were often considered independent-rather than competing-events, leading to an upward bias of the retrieved estimates. OBJECTIVES The aim of this retrospective cohort study was to evaluate, evaluating through a competing risk analysis, the rates and predictors of mortality and weaning in CIF patients from an Italian referral center. METHODS All adult patients with CIF receiving > 3 mo HPN from 1985 until 2016 were enrolled. Clinical information was collected from the database of the Intestinal Failure Unit of Torino, Italy. Patients were stratified according to the presence or not of short bowel syndrome (SBS). RESULTS The cumulative incidences of death and weaning were 27.3% and 32.3% and 39.0% and 33.7% at 5 and 10 y from HPN initiation, respectively. At multivariable competing risk analyses, mortality was predicted by age (sub-distribution hazard ratio [SHR] = 1.65 per 10-y increase; 95% CI, 1.35-2.01), type 3 SBS (SHR = 0.38; 0.15-0.94), small bowel length ≥ 100 cm (SHR = 0.42; 0.22-0.83), and reconstructive surgery (SHR = 0.11; 0.02-0.64) in SBS patients, and by age (SHR = 1.38 per 10-y increase; 1.16-1.64) and presence of stoma (SHR = 0.30; 0.12-0.78) in non-SBS patients. In the same model, weaning was predicted by type 3 SBS (SHR = 6.86; 3.10-15.16), small bowel length ≥ 100 cm (SHR = 3.54; 1.99-6.30), and reconstructive surgery (SHR = 2.86; 1.44-5.71) in SBS patients, and by age (SHR = 0.79 per 10-y increase; 0.66-0.94) and presence of stoma (SHR = 2.64; 1.38-5.07) in non-SBS patients. CONCLUSIONS Surgical procedures strongly affected mortality and weaning risk in CIF patients.
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Affiliation(s)
- Chiara D'Eusebio
- Department of Medical Science, University of Torino, 10124 Torino, Italy
| | - Fabio Dario Merlo
- Unit of Dietetic and Clinical Nutrition, Città della Salute e della Scienza Hospital, 10126 Torino, Italy.
| | - Marta Ossola
- Unit of Dietetic and Clinical Nutrition, Città della Salute e della Scienza Hospital, 10126 Torino, Italy
| | - Fabio Bioletto
- Department of Medical Science, University of Torino, 10124 Torino, Italy
| | - Mirko Ippolito
- Department of Medical Science, University of Torino, 10124 Torino, Italy
| | - Monica Locatelli
- Food Chemistry, Biotechnology and Nutrition Unit, University of Piemonte Orientale, 28100 Novara, Italy
| | - Antonella De Francesco
- Unit of Dietetic and Clinical Nutrition, Città della Salute e della Scienza Hospital, 10126 Torino, Italy
| | - Marta Anrò
- Unit of Dietetic and Clinical Nutrition, Città della Salute e della Scienza Hospital, 10126 Torino, Italy
| | - Renato Romagnoli
- General Surgery 2U, Liver Transplantation Unit, Città della Salute e della Scienza Hospital, 10126 Torino, Italy
| | - Paolo Strignano
- General Surgery 2U, Liver Transplantation Unit, Città della Salute e della Scienza Hospital, 10126 Torino, Italy
| | - Simona Bo
- Unit of Dietetic and Clinical Nutrition, Città della Salute e della Scienza Hospital, 10126 Torino, Italy.
| | - Umberto Aimasso
- Unit of Dietetic and Clinical Nutrition, Città della Salute e della Scienza Hospital, 10126 Torino, Italy
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Fumagalli RM, Aimasso U, Valeriani E, Mumoli N, Szlaszynska M, Antonucci E, Palareti G, Mastroiacovo D, Di Nisio M, Barco S. Quality of warfarin anticoagulation in adults with short bowel syndrome on home parenteral nutrition. VASA 2022; 51:320-322. [PMID: 36059217 DOI: 10.1024/0301-1526/a001018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | - Umberto Aimasso
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Torino, Italy
| | - Emanuele Valeriani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Nicola Mumoli
- Department of Internal Medicine, Magenta Hospital, Magenta, Italy.,Department of Internal Medicine, Livorno Hospital, Livorno, Italy
| | | | | | | | | | - Marcello Di Nisio
- Department of Medicine and Ageing Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Stefano Barco
- Department of Angiology, University Hospital Zurich, Switzerland.,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Bioletto F, D’Eusebio C, Merlo FD, Aimasso U, Ossola M, Pellegrini M, Ponzo V, Chiarotto A, De Francesco A, Ghigo E, Bo S. Efficacy of Teduglutide for Parenteral Support Reduction in Patients with Short Bowel Syndrome: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14040796. [PMID: 35215445 PMCID: PMC8880479 DOI: 10.3390/nu14040796] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 12/13/2022] Open
Abstract
Teduglutide has been described as an effective treatment for parenteral support (PS) reduction in patients with short bowel syndrome (SBS). However, a quantitative summary of the available evidence is still lacking. PubMed/Medline, EMBASE, Cochrane library, OVID, and CINAHL databases were systematically searched up to July 2021 for studies reporting the rate of response (defined as a ≥20% reduction in PS) to teduglutide among PS-dependent adult patients. The rate of weaning (defined as the achievement of PS independence) was also evaluated as a secondary end-point. Ten studies were finally considered in the meta-analysis. Pooled data show a response rate of 64% at 6 months, 77% at 1 year and, 82% at ≥2 years; on the other hand, the weaning rate could be estimated as 11% at 6 months, 17% at 1 year, and 21% at ≥2 years. The presence of colon in continuity reduced the response rate (-17%, 95%CI: (-31%, -3%)), but was associated with a higher weaning rate (+16%, 95%CI: (+6%, +25%)). SBS etiology, on the contrary, was not found to be a significant predictor of these outcomes, although a nonsignificant trend towards both higher response rates (+9%, 95%CI: (-8%, +27%)) and higher weaning rates (+7%, 95%CI: (-14%, +28%)) could be observed in patients with Crohn's disease. This was the first meta-analysis that specifically assessed the efficacy of teduglutide in adult patients with SBS. Our results provide pooled estimates of response and weaning rates over time and identify intestinal anatomy as a significant predictor of these outcomes.
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Affiliation(s)
- Fabio Bioletto
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (F.B.); (C.D.); (M.P.); (V.P.); (E.G.)
| | - Chiara D’Eusebio
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (F.B.); (C.D.); (M.P.); (V.P.); (E.G.)
| | - Fabio Dario Merlo
- Dietetic Unit, Città della Salute e della Scienza Hospital, 10126 Turin, Italy; (F.D.M.); (U.A.); (M.O.); (A.C.); (A.D.F.)
| | - Umberto Aimasso
- Dietetic Unit, Città della Salute e della Scienza Hospital, 10126 Turin, Italy; (F.D.M.); (U.A.); (M.O.); (A.C.); (A.D.F.)
| | - Marta Ossola
- Dietetic Unit, Città della Salute e della Scienza Hospital, 10126 Turin, Italy; (F.D.M.); (U.A.); (M.O.); (A.C.); (A.D.F.)
| | - Marianna Pellegrini
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (F.B.); (C.D.); (M.P.); (V.P.); (E.G.)
| | - Valentina Ponzo
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (F.B.); (C.D.); (M.P.); (V.P.); (E.G.)
| | - Alessia Chiarotto
- Dietetic Unit, Città della Salute e della Scienza Hospital, 10126 Turin, Italy; (F.D.M.); (U.A.); (M.O.); (A.C.); (A.D.F.)
| | - Antonella De Francesco
- Dietetic Unit, Città della Salute e della Scienza Hospital, 10126 Turin, Italy; (F.D.M.); (U.A.); (M.O.); (A.C.); (A.D.F.)
| | - Ezio Ghigo
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (F.B.); (C.D.); (M.P.); (V.P.); (E.G.)
| | - Simona Bo
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (F.B.); (C.D.); (M.P.); (V.P.); (E.G.)
- Correspondence: ; Tel.: +39-011-633-6036
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Pironi L, Steiger E, Joly F, Jeppesen PB, Wanten G, Sasdelli AS, Chambrier C, Aimasso U, Mundi MS, Szczepanek K, Jukes A, Theilla M, Kunecki M, Daniels J, Serlie M, Poullenot F, Cooper SC, Rasmussen HH, Compher C, Seguy D, Crivelli A, Santarpia L, Guglielmi FW, Kozjek NR, Schneider SM, Ellegard L, Thibault R, Matras P, Matysiak K, Van Gossum A, Forbes A, Wyer N, Taus M, Virgili NM, O'Callaghan M, Chapman B, Osland E, Cuerda C, Udvarhelyi G, Jones L, Won Lee AD, Masconale L, Orlandoni P, Spaggiari C, Díez MB, Doitchinova-Simeonova M, Serralde-Zúñiga AE, Olveira G, Krznaric Z, Czako L, Kekstas G, Sanz-Paris A, Jáuregui MEP, Murillo AZ, Schafer E, Arends J, Suárez-Llanos JP, Youssef NN, Brillanti G, Nardi E, Lal S. Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey. Clin Nutr ESPEN 2021; 45:433-441. [PMID: 34620351 DOI: 10.1016/j.clnesp.2021.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/08/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND AIMS The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. METHODS The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. 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 categorized as <1, 1-2, 2-3 and >3 L/day. RESULTS In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. CONCLUSIONS SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.
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Affiliation(s)
- Loris Pironi
- CHU Rennes, Nutrition Unit, Clinique Saint Yves, Home Parenteral Nutrition Centre, INRAE, INSERM, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France.
| | - Ezra Steiger
- Home Nutrition Support, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Francisca Joly
- Centre for Intestinal Failure, Department of Gastroenterology and Nutritional Support, Hôpital Beaujon, Clichy, France
| | - Palle B Jeppesen
- Rigshospitalet, Department of Gastroenterology, Copenhagen, Denmark
| | - Geert Wanten
- Intestinal Failure Unit, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Anna S Sasdelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Centre for Chronic Intestinal Failure - Clinical Nutrition and Metabolism Unit, Bologna, Italy
| | - Cecile Chambrier
- Unité de Nutrition Clinique Intensive, Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France
| | | | - Manpreet S Mundi
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo College of Medicine, Rochester, MN, USA
| | - Kinga Szczepanek
- General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland
| | - Amelia Jukes
- University Hospital of Wales, Cardiff, United Kingdom
| | - Miriam Theilla
- Rabin Medical Center, Petach Tikva, Sackler School of Medicine, Tel Aviv University, Israel
| | | | - Joanne Daniels
- Nottingham University Hospital NHS Trust, Nottingham, United Kingdom
| | - Mireille Serlie
- Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Florian Poullenot
- Service de Gastroentérologie, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Sheldon C Cooper
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Henrik H Rasmussen
- Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
| | - Charlene Compher
- Hospital of the University of Pennsylvania, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - David Seguy
- Service de Nutrition, CHRU de Lille, Lille, France
| | - Adriana Crivelli
- Unidad de Soporte Nutricional, Rehabilitación y Trasplante de Intestino, Hospital Universitario Fundacion Favaloro, Buenos Aires, Argentina
| | | | | | | | - Stéphane M Schneider
- Gastroenterology and Clinical Nutrition, CHU of Nice, Université Côte D'Azur, Nice, France
| | - Lars Ellegard
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Ronan Thibault
- CHU Rennes, Nutrition Unit, Clinique Saint Yves, Home Parenteral Nutrition Centre, INRAE, INSERM, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
| | - Przemysław Matras
- Department of General and Transplant Surgery and Clinical Nutrition, Medical University of Lublin, Lublin, Poland
| | - Konrad Matysiak
- Centre for Intestinal Failure, Department of General, Endocrinological and Gastroenterological Surgery, Poznań University of Medical Science, Poznań, Poland
| | - Andrè Van Gossum
- Medico-Surgical Department of Gastroenterology, Hôpital Erasme, Free University of Brussels, Belgium
| | - Alastair Forbes
- Institute of Internal Medicine, University of Tartu, Tartu, Estonia, And Previously at Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - Nicola Wyer
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, United Kingdom
| | - Marina Taus
- SOD Dietetica e Nutrizione Clinica, Centro Riferimento Regionale NAD, Ospedali Riuniti di Ancona, Italy
| | - Nuria M Virgili
- Facultatiu Especialista. Servei D'Endocrinologia I Nutrició, Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | | | - Emma Osland
- Royal Brisbane and Women's Hospital, Herston, Australia
| | - Cristina Cuerda
- Nutrition Unit, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | | | - Lynn Jones
- Royal Prince Alfred Hospital, Camperdown, Australia
| | - Andre D Won Lee
- Hospital Das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Paolo Orlandoni
- Nutrizione Clinica-Centro di Riferimento Regionale NAD, IRCCS-INRCA, Ancona, Italy
| | | | - Marta Bueno Díez
- Servei D'Endocrinologia I Nutrició, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | | | | | | | - Zeljko Krznaric
- Centre of Clinical Nutrition, Department of Medicine, University Hospital Centre, Zagreb, Croatia
| | - Laszlo Czako
- First Department of Internal Medicine, Szeged, Hungary
| | | | | | | | | | - Eszter Schafer
- Magyar Honvedseg Egészségügyi Központ (MHEK), Budapest, Hungary
| | - Jann Arends
- Department of Medicine, Oncology and Hematology, University of Freiburg, Germany
| | - José P Suárez-Llanos
- Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Nader N Youssef
- VectivBio AG Basel, Switzerland, Digestive Healthcare Center, NJ, USA
| | - Giorgia Brillanti
- Alma Mater Studiorum, University of Bologna, Department of Medical and Surgical Sciences, Bologna, Italy
| | - Elena Nardi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Simon Lal
- Intestinal Failure Unit, Salford Royal Foundation Trust, Salford, UK
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8
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Pironi L, Steiger E, Joly F, Wanten GJA, Chambrier C, Aimasso U, Sasdelli AS, Szczepanek K, Jukes A, Theilla M, Kunecki M, Daniels J, Serlie MJ, Cooper SC, Poullenot F, Rasmussen HH, Compher CW, Crivelli A, Hughes SJ, Santarpia L, Guglielmi FW, Rotovnik Kozjek N, Ellegard L, Schneider SM, Matras P, Forbes A, Wyer N, Zmarzly A, Taus M, O'Callaghan M, Osland E, Thibault R, Cuerda C, Jones L, Chapman B, Sahin P, Virgili NM, Lee ADW, Orlandoni P, Matysiak K, Di Caro S, Doitchinova-Simeonova M, Masconale L, Spaggiari C, Garde C, Serralde-Zúñiga AE, Olveira G, Krznaric Z, Petrina Jáuregui E, Zugasti Murillo A, Suárez-Llanos JP, Nardi E, Van Gossum A, Lal S. Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure. Gut 2020; 69:1787-1795. [PMID: 31964752 DOI: 10.1136/gutjnl-2018-318172] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 12/23/2019] [Accepted: 01/07/2020] [Indexed: 12/14/2022]
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.
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Affiliation(s)
- Loris Pironi
- Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Ezra Steiger
- Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Francisca Joly
- Service de Gastroentérologie et d'Assistance nutritive, Hôpital Beaujon, Assistance Publique - Hopitaux de Paris, University of Paris, Clichy, France
| | - Geert J A Wanten
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Cecile Chambrier
- Centre Hospitalier Universitaire de Lyon, Lyon, Rhône-Alpes, France
| | - Umberto Aimasso
- Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino, Torino, Piemonte, Italy
| | | | | | - Amelia Jukes
- University Hospital of Wales, Cardiff, Cardiff, UK
| | - Miriam Theilla
- Nursing Department, Steyer School of Health Professions, Sackler School of Medicine, Tel Aviv, Israel
| | - Marek Kunecki
- Clinical Nutrition Department, M Pirogow Hospital, Lodz, Poland
| | - Joanne Daniels
- Nottingham University Hospital NHS Trust, Nottingham, UK
| | - Mireille J Serlie
- Endocrinology and Metabolism, Academic Medical Center, Amsterdam, The Netherlands
| | - Sheldon C Cooper
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK
| | - Florian Poullenot
- Hôpital Haut-Lévêque, Service d'hépato-gastroentérologie, CHU Bordeaux, Pessac, France
| | - Henrik Højgaard Rasmussen
- Center for Nutrition and Bowel Disease, Department of Medical Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
| | - Charlene W Compher
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Adriana Crivelli
- Fundacion Favaloro Hospital Universitario, Buenos Aires, Federal District, Argentina
| | | | - Lidia Santarpia
- Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II, Napoli, Campania, Italy
| | | | | | | | - Stéphane M Schneider
- Centre Hospitalier Universitaire de Nice, Nice, Provence-Alpes-Côte d'Azur, France
| | | | - Alastair Forbes
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK
| | - Nicola Wyer
- University Hospital Coventry, Coventry, Coventry, UK
| | | | - Marina Taus
- Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Umberto I G M Lancisi G Salesi, Ancona, Marche, Italy
| | | | - Emma Osland
- Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia
| | - Ronan Thibault
- 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
| | - Cristina Cuerda
- Hospital General Universitario Gregorio Maranon, Madrid, Madrid, Spain
| | - Lynn Jones
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Brooke Chapman
- Nutrition and Dietetics, Austin Health, Heidelberg, Victoria, Australia
| | | | - Núria M Virgili
- Unitat de Nutrició i Dietètica, Hospital Universitari Bellvitge, L'Hospitalet Llobregat, Barcelona, Spain
| | - Andre Dong Won Lee
- Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Konrad Matysiak
- Centre for Intestinal Failure, Uniwersytet Medyczny imienia Karola Marcinkowskiego w Poznaniu, Poznan, Poland
| | | | | | - Luisa Masconale
- Unita' Locale Socio-Sanitaria N° 22, Bussolengo, Verona, Italy
| | - Corrado Spaggiari
- Azienda Unita Sanitaria Locale di Parma, Parma, Emilia-Romagna, Italy
| | - Carmen Garde
- Hospital Universitario de Donostia, San Sebastian, País Vasco, Spain
| | | | - Gabriel Olveira
- Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | | | | | | | - José P Suárez-Llanos
- Hospital Universitario Nuestra Senora de la Candelaria, Santa Cruz de Tenerife, Canarias, Spain
| | - Elena Nardi
- Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - André Van Gossum
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Simon Lal
- Gastroenterology and Intestinal Failure Unit, Salford Royal Foundation Trust, University of Manchester, Manchester, UK
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Aimasso U, Ippolito M, Pira C, Devecchi A. Proteins daily distribution and body composition changes in weight-loss. MINERVA GASTROENTERO 2020; 66:299-300. [PMID: 32623871 DOI: 10.23736/s1121-421x.20.02731-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Umberto Aimasso
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy -
| | - Mirko Ippolito
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy
| | - Costanza Pira
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy
| | - Andrea Devecchi
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy
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Loria D, Aimasso U, Fedele D, Golzio P, Merlo F, Mollo A, De Francesco A. BODY COMPOSITION AND NUTRITIONAL INTAKES IN PATIENTS WITH SHORT BOWEL SYNDROME IN HOME PARENTERAL NUTRITION. Nutrition 2020. [DOI: 10.1016/j.nut.2020.110919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Aimasso U, Capello E, Fadda M, Merlo F, De Francesco A, Mussa B. MON-PO467: Septic, Thrombotic and Mechanical Complications in Central Venous Catheters of Non Oncologic Patients in Home Parenteral Nutrition for Chronic Intestinal Failure. A Retrospective Observation Study. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32300-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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12
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De Francesco A, Diamanti A, Gandullia P, Aimasso U, Arrigo S, Brolatti N, Capriati T, Elia D, Mazzuoli S, Merlo FD, Pazzeschi C, Regano N, Sasdelli AS, Pironi L, Guglielmi FW. Non-interventional, retrospective data of long-term home parenteral nutrition in patients with benign diseases: Analysis of a nurse register (SERECARE). Nutrition 2019; 66:131-141. [PMID: 31276929 DOI: 10.1016/j.nut.2019.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/02/2019] [Accepted: 01/17/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the safety and efficacy of home parenteral nutrition (HPN) service in patients with benign chronic intestinal failure (CIF). METHODS This was a 10-y retrospective, non-interventional, multicenter study conducted with adult and pediatric patients with CIF who received HPN service. We analyzed data prospectively collected from a dedicated register by HPN nurses. RESULTS From January 2002 to December 2011 a total of 794 patients (49.7% male, median age 1 y for children and 57 y for adults) were included in the analysis. Over the 10-y period, 723 central venous catheter (CVC) complications occurred, of which 394 were infectious (54.5%), 297 were mechanical (41.1%), and 32 (3.3%) were defined as CVC-related thrombosis. The complication rate was higher in children (1.11 per patient) than in adults (0.70 per patient). During the observation period, the rates of both infectious and mechanical complications showed a global declining trend and ∼75% of patients had neither infectious nor mechanical CVC complications. HPN efficacy was evaluated in 301 patients with a minimum follow-up of 36 mo. Body mass index and Karnofsky score showed that the median growth significantly increased (P < 0.001) over baseline for adults and pediatric patients in the 0 to 2 age range. CONCLUSIONS The use of a structured register has proved to be a key strategy for monitoring the outcomes of long-term treatment, improving time efficiency, and preventing potential malpractice. To our knowledge, this is the largest survey ever documented; the results were consistent despite the heterogeneity of the centers because of duly applied standard rules and protocols.
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Affiliation(s)
| | | | - Paolo Gandullia
- Istituto di Ricerca e Cura a Carattere Scientifico Istituto G. Gaslini, Genova, Italy
| | - Umberto Aimasso
- Azienda Ospedaliera Città della Salute e della Scienza, Torino, Italy
| | - Serena Arrigo
- Istituto di Ricerca e Cura a Carattere Scientifico Istituto G. Gaslini, Genova, Italy
| | - Noemi Brolatti
- Istituto di Ricerca e Cura a Carattere Scientifico Istituto G. Gaslini, Genova, Italy
| | | | | | | | - Fabio Dario Merlo
- Azienda Ospedaliera Città della Salute e della Scienza, Torino, Italy
| | | | | | | | - Loris Pironi
- Azienda Ospedaliera Universitaria S. Orsola Malpighi, Bologna, Italy
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13
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Aimasso U, D'onofrio V, D'eusebio C, Devecchi A, Pira C, Merlo FD, De Francesco A. Helicobacter pylori and nutrition: a bidirectional communication. MINERVA GASTROENTERO 2019; 65:116-129. [PMID: 30759976 DOI: 10.23736/s1121-421x.19.02568-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Helicobacter pylori (HP) is a gram-negative flagellated pathogen acid-resistant bacterium; it belongs to the order Campylobacterales that is wide spread all over the world, infecting more than 50% of the world population. HP infection is etiologically associated with non-atrophic and atrophic gastritis, peptic ulcer and with 3 to 6-fold increased relative risk for developing gastric adenocarcinoma and mucosa-associated lymphoid tissue (MA LT) lymphoma. For this reason HP is recognized by the World Health Organization as a Class I human carcinogen. In the last years a lot of studies clarified the role of this pathogen in nutrition and metabolism; particularly, it has been shown that it is able to induce malabsorption of several nutrients like iron, cobalamin, vitamin C and vitamin E, with strong consequences on nutritional status. Interesting, this bacterium is able to produce different biological effects on hormones like ghrelin and leptin controlling both appetite and growth, mostly depending on the time of acquisition of the infection and of its treatment. In this review, the authors focused their attention on nutritional effects of HP infection and particularly on the role that diet, food, plants and specific nutrients can play in its treatment, considering that HP eradication rates, with standard triple-therapy, have fallen to a low level in the last years.
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Affiliation(s)
- Umberto Aimasso
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy -
| | - Valentina D'onofrio
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy
| | - Chiara D'eusebio
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy
| | - Andrea Devecchi
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy
| | - Costanza Pira
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy
| | - Fabio D Merlo
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy
| | - Antonella De Francesco
- Unit of Dietetics and Clinical Nutrition, Città della Salute e della Scienza, Turin, Italy
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Aimasso U, Merlo FD, De Francesco A, Strignano P, Romagnoli R. Diaphragm disease: complete small bowel obstruction after long-term nonsteroidal anti-inflammatory drugs use. Gazz Med Ital - Arch Sci Med 2017. [DOI: 10.23736/s0393-3660.17.03483-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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15
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Merlo F, Ivaldi C, Aimasso U, De Francesco A. MON-LB329: Taurolidine-Citrate CVC-Lock Solution Reduces CRBSI Rate in Patients with Chronic Intestinal Failure in HPN. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)31097-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Pironi L, Konrad D, Brandt C, Joly F, Wanten G, Agostini F, Chambrier C, Aimasso U, Zeraschi S, Kelly D, Szczepanek K, Jukes A, Di Caro S, Theilla M, Kunecki M, Daniels J, Serlie M, Poullenot F, Wu J, Cooper SC, Rasmussen HH, Compher C, Seguy D, Crivelli A, Pagano MC, Hughes SJ, Guglielmi FW, Kozjek NR, Schneider SM, Gillanders L, Ellegard L, Thibault R, Matras P, Zmarzly A, Matysiak K, Van Gossum A, Forbes A, Wyer N, Taus M, Virgili NM, O'Callaghan M, Chapman B, Osland E, Cuerda C, Sahin P, Jones L, Lee ADW, Bertasi V, Orlandoni P, Izbéki F, Spaggiari C, Díez MB, Doitchinova-Simeonova M, Garde C, Serralde-Zúñiga AE, Olveira G, Krznaric Z, Czako L, Kekstas G, Sanz-Paris A, Jáuregui EP, Murillo AZ, Schafer E, Arends J, Suárez-Llanos JP, Shaffer J, Lal S. Clinical classification of adult patients with chronic intestinal failure due to benign disease: An international multicenter cross-sectional survey. Clin Nutr 2017; 37:728-738. [PMID: 28483328 DOI: 10.1016/j.clnu.2017.04.013] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/19/2017] [Accepted: 04/11/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS The aim of the study was to evaluate the applicability of the ESPEN 16-category clinical classification of chronic intestinal failure, based on patients' intravenous supplementation (IVS) requirements for energy and fluids, and to evaluate factors associated with those requirements. METHODS ESPEN members were invited to participate through ESPEN Council representatives. Participating centers enrolled adult patients requiring home parenteral nutrition for chronic intestinal failure on March 1st 2015. The following patient data were recorded though a structured database: sex, age, body weight and height, intestinal failure mechanism, underlying disease, IVS volume and energy need. RESULTS Sixty-five centers from 22 countries enrolled 2919 patients with benign disease. One half of the patients were distributed in 3 categories of the ESPEN clinical classification. 9% of patients required only fluid and electrolyte supplementation. IVS requirement varied considerably according to the pathophysiological mechanism of intestinal failure. Notably, IVS volume requirement represented loss of intestinal function better than IVS energy requirement. A simplified 8 category classification of chronic intestinal failure was devised, based on two types of IVS (either fluid and electrolyte alone or parenteral nutrition admixture containing energy) and four categories of volume. CONCLUSIONS Patients' IVS requirements varied widely, supporting the need for a tool to homogenize patient categorization. This study has devised a novel, simplified eight category IVS classification for chronic intestinal failure that will prove useful in both the clinical and research setting when applied together with the underlying pathophysiological mechanism of the patient's intestinal failure.
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Affiliation(s)
- Loris Pironi
- Center for Chronic Intestinal Failure, Department of Digestive System, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Denise Konrad
- Home Nutrition Support, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Francisca Joly
- Centre for Intestinal Failure, Department of Gastroenterology and Nutritional Support, Hôpital Beaujon, Clichy, France
| | - Geert Wanten
- Intestinal Failure Unit, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Federica Agostini
- Center for Chronic Intestinal Failure, Department of Digestive System, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Cecile Chambrier
- Unité de Nutrition Clinique Intensive, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France
| | | | - Sarah Zeraschi
- Nutrition Team Office, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Darlene Kelly
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Kinga Szczepanek
- General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland
| | - Amelia Jukes
- University Hospital of Wales, Cardiff, United Kingdom
| | | | | | | | - Joanne Daniels
- Nottingham University Hospital NHS Trust, Nottingham, United Kingdom
| | | | - Florian Poullenot
- Service de Gastroentérologie, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Jian Wu
- Intestinal Failure Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Sheldon C Cooper
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Henrik H Rasmussen
- Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
| | - Charlene Compher
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - David Seguy
- Service de Nutrition, CHRU de Lille, Lille, France
| | - Adriana Crivelli
- Unidad de Soporte Nutricional, Rehabilitación y Trasplante de Intestino, Hospital Universitario Fundacion Favaloro, Buenos Aires, Argentina
| | | | - Sarah-Jane Hughes
- Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
| | | | | | - Stéphane M Schneider
- Gastroenterology and Clinical Nutrition, CHU of Nice, University of Nice Sophia Antipolis, Nice, France
| | - Lyn Gillanders
- National Intestinal Failure Service, Auckland City Hospital, Auckland, New Zealand
| | - Lars Ellegard
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Ronan Thibault
- Gastrointestinal and Nutritional Rehabilitation Medicine, Clinique Saint Yves, Rennes Cedex, France
| | - Przemysław Matras
- Department of General and Transplant Surgery and Clinical Nutrition, Medical University of Lublin, Lublin, Poland
| | - Anna Zmarzly
- Department of Clinical Nutrition, J. Gromkowski City Hospital, Wroclaw, Poland
| | - Konrad Matysiak
- Centre for Intestinal Failure, Department of General, Endocrinological and Gastroenterological Surgery, Poznan University of Medical Science, Poznań, Poland
| | - Andrè Van Gossum
- Medico-Surgical Department of Gastroenterology, Hôpital Erasme, Free University of Brussels, Belgium
| | - Alastair Forbes
- Norfolk and Norwich University Hospital, University of East Anglia, Norwich, United Kingdom
| | - Nicola Wyer
- University Hospital, Coventry, United Kingdom
| | - Marina Taus
- Centro di Riferimento Regionale NAD Ospedali Riuniti Ancona, Ancona, Italy
| | - Nuria M Virgili
- Unitat Nutrició i Dietética, Servei Endocrinologia i Nutrició, Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | | | - Emma Osland
- Royal Brisbane and Women's Hospital, Herston, Australia
| | - Cristina Cuerda
- Nutrition Unit, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | | | - Lynn Jones
- Royal Prince Alfred Hospital, Camperdown, Australia
| | - Andre D W Lee
- Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Paolo Orlandoni
- Centro di Riferimento Regionale NAD, INRCA -IRCCS, Ancona, Italy
| | - Ferenc Izbéki
- Szent György Teaching Hospital of County Fejér, Székesfehérvár, Hungary
| | | | - Marta Bueno Díez
- Servei d'Endocrinologia i Nutrició, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | | | - Carmen Garde
- Hospital Universitario Donostia, San Sebastian, Spain
| | | | | | - Zeljko Krznaric
- Centre of Clinical Nutrition, Department of Medicine, University Hospital Centre, Zagreb, Croatia
| | - Laszlo Czako
- First Department of Internal Medicine, Szeged, Hungary
| | | | | | | | | | - Eszter Schafer
- Magyar Honvedseg Egészségügyi Központ (MHEK), Budapest, Hungary
| | - Jann Arends
- Department of Medicine, Oncology and Hematology, University of Freiburg, Germany
| | - José P Suárez-Llanos
- Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Jon Shaffer
- Intestinal Failure Unit, Salford Royal Foundation Trust, Salford, UK
| | - Simon Lal
- Intestinal Failure Unit, Salford Royal Foundation Trust, Salford, UK
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