Complications and Monitoring – Guidelines on Parenteral Nutrition, Chapter 11

Hartl, Wolfgang H.; Jauch, Karl‐Walter; Parhofer, Klaus G.; Rittler, P.

doi:10.3205/000076

Cited by 9 publications

(6 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PN nutrition is associated with intestinal and hepatic damage through the atrophy of the gut mucosa and progressive liver damage, often characterized by cholestasis in the early stages [ 48 ]. The development of PN adverse effects, such as fatty liver, elevated bilirubin levels, the appearance of biliary sludge, and cholecystitis, can be highly variable, depending on multiple factors including the patient’s age or disease state [ 49 ]. SLD and elevated transaminases may occur within fourteen days of starting PN.…”

Section: Pathogenetic Mechanisms Of Nafld In Ibdmentioning

confidence: 99%

Inflammatory Bowel Diseases and Non-Alcoholic Fatty Liver Disease: Piecing a Complex Puzzle Together

Maresca,

Mignini,

Varca

et al. 2024

IJMS

View full text Add to dashboard Cite

Inflammatory bowel diseases (IBD), comprising Crohn’s disease and ulcerative colitis, are systemic and multifaceted disorders which affect other organs in addition to the gastrointestinal tract in up to 50% of cases. Extraintestinal manifestations may present before or after IBD diagnosis and negatively impact the intestinal disease course and patients’ quality of life, often requiring additional diagnostic evaluations or specific treatments. Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. Current evidence shows an increased prevalence of NAFLD (and its more advanced stages, such as liver fibrosis and steatohepatitis) in IBD patients compared to the general population. Many different IBD-specific etiopathogenetic mechanisms have been hypothesized, including chronic inflammation, malabsorption, previous surgical interventions, changes in fecal microbiota, and drugs. However, the pathophysiological link between these two diseases is still poorly understood. In this review, we aim to provide a comprehensive overview of the potential mechanisms which have been investigated so far and highlight open issues still to be addressed for future studies.

show abstract

Section: Pathogenetic Mechanisms Of Nafld In Ibdmentioning

confidence: 99%

Inflammatory Bowel Diseases and Non-Alcoholic Fatty Liver Disease: Piecing a Complex Puzzle Together

Maresca,

Mignini,

Varca

et al. 2024

IJMS

View full text Add to dashboard Cite

show abstract

“… 51 The risk of potential complications can be minimized with the help of nutrition support teams. 52 …”

Section: General Managementmentioning

confidence: 99%

Section: General Managementmentioning

confidence: 99%

“…52 TPN is also initiated on an inpatient basis given that refeeding syndrome, which can be seen in severely malnourished patients, usually occurs within the first few days after initiation of TPN. 52,53 Refeeding syndrome includes acute beriberi due to Vitamin B1 deficiency, acute volume overload leading to anasarca and pulmonary edema, dyselectrolytemia including hypophosphatemia, hypokalemia and hypomagnesemia, arrhythmias including bradycardia and ventricular arrhythmia, hyperglycemia which if left untreated can lead to hyperosmolar coma. 52 Malnutrition and cachexia are usually irreversible and treatment-resistant, 54 especially in those patients who are heavily pre-treated and have platinum-resistant disease.…”

Section: Hydrationmentioning

confidence: 99%

“…52,53 Refeeding syndrome includes acute beriberi due to Vitamin B1 deficiency, acute volume overload leading to anasarca and pulmonary edema, dyselectrolytemia including hypophosphatemia, hypokalemia and hypomagnesemia, arrhythmias including bradycardia and ventricular arrhythmia, hyperglycemia which if left untreated can lead to hyperosmolar coma. 52 Malnutrition and cachexia are usually irreversible and treatment-resistant, 54 especially in those patients who are heavily pre-treated and have platinum-resistant disease. The European Society for Clinical Nutrition and Metabolism (ESPEN) practical guidelines for clinical nutrition reported that parenteral hydration and nutrition are unlikely to provide any benefit for most patients at the end of life.…”

Section: Hydrationmentioning

confidence: 99%

See 2 more Smart Citations

Inoperable Bowel Obstruction in Ovarian Cancer: Prevalence, Impact and Management Challenges

González-Ochoa

Alqaisi

Bhat

et al. 2022

IJWH

View full text Add to dashboard Cite

Malignant bowel obstruction (MBO) is one of the most severe complications in patients with advanced ovarian cancer, with an estimated incidence up to 50%. Its presence is related to poor prognosis and a life expectancy measured in weeks for inoperable cases. Symptoms are usually difficult to manage and often require hospitalization, which carries a high burden on patients, caregivers and the healthcare system. Management is complex and requires a multidisciplinary approach to improve clinical outcomes. Patients with inoperable MBO are treated medically with analgesics, antiemetics, steroids and antisecretory agents. Parenteral nutrition and gut decompression with nasogastric tube, venting gastrostomy or stenting may be used as supportive therapy. Treatment decision-making is challenging and often based on clinical expertise and local policies, with lack of high-quality evidence to optimally standardize management. The present review summarizes current literature on inoperable bowel obstruction in ovarian cancer, focusing on epidemiology, prognostic factors, clinical outcomes, medical management, multidisciplinary interventions and quality of life.

show abstract

Beyond lipids: Novel mechanisms for parenteral nutrition–associated liver disease

et al. 2022

View full text Add to dashboard Cite

Parenteral nutrition (PN) is a therapy that delivers essential nutrients intravenously to patients who are unable to meet their nutrition requirements via standard enteral feeding. This methodology is often referred to as PN when accompanied by minimal or no enteral nutrition (EN). Although PN is lifesaving, significant complications can arise, such as intestinal failure–associated liver disease and gut‐mucosal atrophy. The exact mechanism of injury remains ill defined. This review was designed to explore the available literature related to the drivers of injury mechanisms. The Farnesoid X receptor and fibroblast growth factor 19 signaling pathway seems to play an important role in gut‐systemic signaling, and its alteration during PN provides insights into mechanistic links. Central line infections also play a key role in mediating PN‐associated injury. Although lipid reduction strategies, as well as the use of multicomponent lipid emulsions and vitamin E, have shown promise, the cornerstone of preventing injury is the early establishment of EN.

show abstract

Complications and Monitoring – Guidelines on Parenteral Nutrition, Chapter 11

Cited by 9 publications

References 50 publications

Inflammatory Bowel Diseases and Non-Alcoholic Fatty Liver Disease: Piecing a Complex Puzzle Together

Inflammatory Bowel Diseases and Non-Alcoholic Fatty Liver Disease: Piecing a Complex Puzzle Together

Inoperable Bowel Obstruction in Ovarian Cancer: Prevalence, Impact and Management Challenges

Beyond lipids: Novel mechanisms for parenteral nutrition–associated liver disease

Contact Info

Product

Resources

About