ASPEN‐FELANPE Clinical Guidelines

Kumpf, Vanessa J.; Aguilar-Nascimento, José Eduardo de; Graf, José Ignacio Díaz-Pizarro; Hall, Amber M.; McKeever, Liam; Steiger, Ezra; Winkler, Marion F.; Compher, Charlene

doi:10.1177/0148607116680792

Cited by 64 publications

(60 citation statements)

References 41 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, several studies have validated albumin as a good predictor of morbidity making it still a clinically relevant marker, possibly because it captures information on both malnutrition and degree of inflammatory state. Thus, its routine measurement remains recommended in the latest ASPEN clinical guidelines for enterocutaneous fistula management (27). …”

Section: Discussionmentioning

confidence: 99%

“…Patients can be maintained with enteral/parenteral nutritional support and wound care/management for a prolonged period, allowing for improvements in nutritional status and control of chronic co-morbidities before pursuing elective repair(18, 19, 27). In fact, recent literature demonstrates that waiting for a longer interim before definitive repair significantly improves outcomes, with an average wait time of 12 months vs. 8 months having improved success and post-operative survival(18, 19).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Computed Tomography–Measured Psoas Density Predicts Outcomes After Enterocutaneous Fistula Repair

Evans

Yoo

2017

J Parenter Enteral Nutr

View full text Add to dashboard Cite

BackgroundLow muscle mass and quality are associated with poor surgical outcomes. We evaluated computed tomography (CT)–measured psoas muscle density as a marker of muscle quality and physiologic reserve and hypothesized that it predicts poor outcomes after enterocutaneous fistula repair (ECF).MethodsWe conducted a retrospective cohort study of patients 18–90 years old with ECF who failed nonoperative management, requiring elective operative repair at The Ohio State University (2005–2016), and who received preoperative abdomen/pelvis CT scan with intravenous contrast within 3 months of the operation. Psoas Hounsfield unit average calculations were measured at the L3 level. One‐year leak rate, mortality (90 days, 1 years, and 3 years), complication risk, length of stay, dependent discharge, and 30‐day readmission were compared with Hounsfield unit average calculation (HUAC).ResultsOne hundred patients met inclusion criteria. Patients were stratified into interquartile ranges based on HUAC. The lowest HUAC interquartile was our low muscle quality (LMQ) cutoff, which was associated with 1‐year leak (relative risk [RR] = 2.10, P < .005), 1‐year mortality (RR = 2.22, P < .04) and 3‐year mortality (RR = 2.13, P < .007), complication risk (RR = 1.54, P < .001), and dependent discharge (RR = 2.50, P < .004) compared to patients without LMQ.ConclusionsPsoas muscle density is a significant predictor of poor outcomes in ECF repair. This readily available measure of physiologic reserve can identify patients with ECF who have increased risk and may benefit from additional interventions and recovery time before operative repair.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Computed Tomography–Measured Psoas Density Predicts Outcomes After Enterocutaneous Fistula Repair

Evans

Yoo

2017

J Parenter Enteral Nutr

View full text Add to dashboard Cite

show abstract

“…Specific research gaps in the evidence base for nutrition support practice are summarized in Table , some of which were identified by the evidence review in development of clinical guidelines . A pivotal research goal is the validation of the consensus strategies for the identification of malnutrition in adult and pediatric patients in varied clinical settings.…”

Section: Health Services Researchmentioning

confidence: 99%

“…Specific research gaps in the evidence base for nutrition support practice are summarized in Table 2, some of which were identified by the evidence review in development of clinical guidelines. [15][16][17] A pivotal research goal is the validation of the consensus strategies for the identification of malnutrition in adult and pediatric patients in varied clinical settings. Objective, clinically available measures of change in body composition could identify levels of malnutrition risk and clarify varied responses to nutrition support therapy.…”

Section: Health Services Researchmentioning

confidence: 99%

Research Agenda 2018: The American Society for Parenteral and Enteral Nutrition

Compher

Jain

Nichol

et al. 2018

J Parenter Enteral Nutr

View full text Add to dashboard Cite

“…However, the indications, methods, benefits, and any problems associated with chyme reinfusion (CR) are poorly collated in the literature at present. There is a need for clarification of the role of CR in patients with high outputs …”

Section: Introductionmentioning

confidence: 99%

Chyme Reinfusion for Small Bowel Double Enterostomies and Enteroatmospheric Fistulas in Adult Patients: A Systematic Review

et al. 2019

View full text Add to dashboard Cite

Background High‐output double enterostomies (DESs) and enteroatmospheric fistulas (EAFs) of the small bowel account for substantial patient morbidity and mortality. Management may include parenteral nutrition (PN) and prolonged admissions, at high cost. Reinfusion of chyme into the distal bowel is a proposed therapeutic alternative when the distal DES limb is accessible; however, standardized information on this technique is required. This review aimed to critically assess the literature regarding chyme reinfusion (CR) to define its current status and future directions. Methods A systematic search of medical databases was conducted for articles investigating CR in adults. Articles reporting indications, methods, benefits, technical issues, and complications resulting from CR were reviewed. A narrative synthesis of the retrieved data was undertaken. Results In total, 24 articles reporting 481 cases of CR were identified, although articles were heterogeneous in their structure and reporting. CR was most frequently performed for remediation of high‐output DES and intestinal failure and for proximally located DES. Effluent output collection was commonly manual, with distal reinfusion more commonly automated, and with few dedicated systems. Multiple benefits attributed to CR were reported, encompassing weight gain, cessation of PN, and improvements in liver function. Technical problems included distaste, labor‐intensive methods, reflux of contents, and tube dislodgement. No serious AEs or mortality directly attributable to CR were reported. Conclusions CR appears to be a promising, safe and well‐validated intervention for small bowel DES and EAF. However, more efficient and acceptable methods are required to promote greater adoption of the practice of CR.

show abstract

ASPEN‐FELANPE Clinical Guidelines

Cited by 64 publications

References 41 publications

Computed Tomography–Measured Psoas Density Predicts Outcomes After Enterocutaneous Fistula Repair

Computed Tomography–Measured Psoas Density Predicts Outcomes After Enterocutaneous Fistula Repair

Research Agenda 2018: The American Society for Parenteral and Enteral Nutrition

Chyme Reinfusion for Small Bowel Double Enterostomies and Enteroatmospheric Fistulas in Adult Patients: A Systematic Review

Contact Info

Product

Resources

About