Metabolic consequences of patients with gastrointestinal fistulas

Dudrick, Stanley J.; Panait, Lucian

doi:10.1007/s00068-011-0102-9

Cited by 21 publications

(17 citation statements)

References 30 publications

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“…Several studies have recommended individualizing nutritional management plan and feeding routes to provide calorie and protein. 12 We attempted to provide 3000kcal to many patients enterally though it was not possible in all patients. We found that 31% required, in addition, nasogastric intubation and other supplements in the form of amino acid preparation to boost nutrition (Table 3).…”

Section: Discussionmentioning

confidence: 99%

Experience with enterocutaneous fistula management in a district hospital in Nigeria

Bawa¹,

Sule²,

Grimah³

et al. 2016

East. Cent. Afr. J. Surg.

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Background: Enterocutaneous fistula (ECF) is an abnormal communication between gastrointestinal tract and skin. It is a difficult condition to treat and morbidity and mortality remain high in many centers. Malnutrition and sepsis are the leading causes of death. There are no clear guidelines for optimal nutritional management. Aggressive measures to maintain positive nitrogen balance is the ultimate goal of nutritional management. Our objective was to review the practice of the nutritional management and outcome of ECF in a resource limited setting in Nigeria. Methods: A retrospective study of all patients with ECF managed between 2006 and 2015. Management included resuscitation, control of sepsis, enteral feeding, skin care and timely surgical intervention. Results: A total of 57 patients were managed. Aetiology of ECF in this study was postoperative in 96.5% of cases. Fistula closure was achieved in 51/57 patients (89.5%). Thirtynine (68.42%) fistulae closed spontaneously on conservative management while 12 (21.05%) fistulae healed following restorative surgery. Mortality rate was 10.5%. Rate of healing was related to serum albumin level and fistula output. Conclusion: Aggressive enteral feeding allows a favorable outcome in enterocutaneous fistula after a convalescence period. High output and hypoalbuminaemia were important prognostic variables.

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Section: Discussionmentioning

confidence: 99%

Experience with enterocutaneous fistula management in a district hospital in Nigeria

Bawa¹,

Sule²,

Grimah³

et al. 2016

East. Cent. Afr. J. Surg.

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“…Three recent review articles recommend a protein dose of 1.5 g/kg/d and kcal to meet basal energy expenditure in patients with low‐output ECF and increasing protein dose to 1.5–2.5 g/kg/d and calorie dose to 1.5–2 times basal energy expenditure in patients with high‐output ECF 29 . ‐ 31 None of the available review articles comment on application to obese patients with ECF, although this represents a significant percentage of the patient population.…”

Section: Resultsmentioning

confidence: 99%

ASPEN‐FELANPE Clinical Guidelines

Kumpf

Aguilar-Nascimento

Graf

et al. 2016

J Parenter Enteral Nutr

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In adult patients with enterocutaneous fistula: (1) What factors best describe nutrition status? (2) What is the preferred route of nutrition therapy (oral diet, enteral nutrition, or parenteral nutrition)? (3) What protein and energy intake provide best clinical outcomes? (4) Is fistuloclysis associated with better outcomes than standard care? (5) Are immune-enhancing formulas associated with better outcomes than standard formulas? (6) Does the use of somatostatin or somatostatin analogue provide better outcomes than standard medical therapy? (7) When is home parenteral nutrition support indicated?

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“…Providing total parenteral nutritional support and restricting oral intake decreases morbidity and mortality in these patients [13][14][15]. Other studies have reported that antibiotic therapy and medical treatments that decrease GI tract secretions, such as somatostatin, are useful to treat these same patient groups [16,17].…”

Section: Discussionmentioning

confidence: 99%