Mortality and parenteral nutrition weaning in patients with chronic intestinal failure on home parenteral nutrition: A 30-year retrospective cohort study

D’Eusebio, Chiara; Merlo, Fabio Dario; Ossola, Marta; Bioletto, Fabio; Ippolito, Mirko; Locatelli, Monica; Francesco, Antonella De; Anrò, Marta; Romagnoli, Renato; Strignano, Paolo; Bo, Simona; Aimasso, Umberto

doi:10.1016/j.nut.2022.111915

Cited by 5 publications

(6 citation statements)

References 48 publications

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“…On the other hand, HPN remains the standard care of those patients with SBS/CIF, but the complications related to HPN are frequent and life-threatening (5). Implementing an HPN program since the SBS/CIF patient was metabolically balanced and non-septic is difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Home parenteral nutrition, the basis for treating short bowel syndrome, is not free of serious complications, such as infection and thrombosis of central venous accesses, metabolic disturbances, and liver failure. The risk of mortality in these cases can reach 10 to 15% when this type of nutrition lasts more than two years (5). The guidelines for HPN are well established and help in a correct SBD/CIF patient orientation (6,7).…”

Section: Introductionmentioning

confidence: 99%

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Management of Short Bowel Syndrome/Chronic Intestinal Failure – the Experience of a Single Portuguese Center

Santos,

Magalhães,

Loureiro

et al. 2024

Preprint

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Aim: To analyze a single center's experience with Short Bowel Syndrome/ Chronic Intestinal Failure (SBS/CIF) in adult patients treated with Home Parenteral Nutrition (HPN). Materials and methods: In the last thirty years, 13 patients with SBS/CIF were included in an HPN program. Results: Between 1992 and 2023, 13 patients were included in an HPN program. The primary underlying pathology was acute mesenteric ischemia. The median age of the starting HPN was 44 years old. Most are submitted to several surgeries of extensive intestinal resection with posterior intestinal reconstruction. Five of the 13 patients have died while on HPN for a median of 42 months. The causes of death HPN-related were catheter sepsis, endocarditis with cardiac failure, or hepatic failure. One patient died due to underlying pathology: pelvic abscesses and bleeding related to radiotherapy. Eight patients remain alive with a median time of HPN of 173 months. During the HPN support, the most frequent complications were venous catheter infection and venous territory thrombosis. None of the eight patients alive have hepatic failure. Two patients recently started teduglutide, with good tolerance, and need reduction of HPN support. All these eight patients have a satisfactory quality of life (parenteral support needs range between five to two nutrition bags per week). Conclusion: HPN remains the gold standard of SBS/CIF treatment, although Teduglutide may reduce HPN needs and HPN complications and provide a better quality of life. An HPN multidisciplinary healthcare group support is essential to ensure these patients' survival and quality of life. Keywords Short bowel Syndrome, Chronic Intestinal failure, Home Parenteral Nutrition, Teduglutide, Complications of Parenteral Support.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of Short Bowel Syndrome/Chronic Intestinal Failure – the Experience of a Single Portuguese Center

Santos,

Magalhães,

Loureiro

et al. 2024

Preprint

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“…The Intestinal Failure Unit database contains information about all patients with CIF since 1985 [ 13 ]. Patients were followed up from their diagnosis of CIF until weaning from PN or death.…”

Section: Methodsmentioning

confidence: 99%

Effects of Treatment with Liraglutide Early after Surgical Intervention on Clinical Outcomes in Patients with Short Bowel Syndrome: A Pilot Observational “Real-Life” Study

et al. 2023

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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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“…This information is invaluable for healthcare professionals and policy-makers as well as researchers. Although many other countries have already established their registries [4][5][6][7][8], there is still a noticeable lack of published data.…”

Section: Introductionmentioning

confidence: 99%

The Czech Home Parenteral Nutrition Registry REDNUP: Comprehensive Analysis of Adult Patients’ Data

Koudelková,

Waldauf,

Wohl

et al. 2024

Ann Nutr Metab

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Introduction: Home parenteral nutrition (HPN) is the primary treatment modality for patients with chronic intestinal failure, one of the least common organ failures. This article provides a retrospective analysis of the data collected on HPN patients in the Czech Republic over the past 30 years. Methods: National registry data was collected using a standardised online form based on the OASIS registry (Oley–A.S.P.E.N. Information System) across all centres providing HPN in the Czech Republic. Data collected prospectively from adult patients in the HPN program was analysed in the following categories: epidemiology, demographics, underlying syndrome, and diagnosis, complications, and teduglutide therapy prevalence. Results: The registry identified a total of 1,838 adult patient records, reflecting almost 1.5 million individual catheter days. The prevalence of HPN has risen considerably over the last few decades, currently reaching 5.5 per 100,000 population. The majority of patients have short bowel syndrome and GI obstruction, with cancer being the most prevalent underlying disease. Catheter-related bloodstream infections have been the most prevalent acute complication. However, the incidence in 2022 was only 0.15 per 1,000 catheter days. The study also observed an increase in the prevalence of patients on palliative HPN over the last decade. Conclusion: This study presents a thorough analysis of data from the Czech REDNUP registry. It shows an increasing prevalence of HPN, namely in the palliative patient group. The sharing of national data can improve understanding of this rare condition and facilitate the development of international guidelines.

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Mortality and parenteral nutrition weaning in patients with chronic intestinal failure on home parenteral nutrition: A 30-year retrospective cohort study

Cited by 5 publications

References 48 publications

Management of Short Bowel Syndrome/Chronic Intestinal Failure – the Experience of a Single Portuguese Center

Management of Short Bowel Syndrome/Chronic Intestinal Failure – the Experience of a Single Portuguese Center

Effects of Treatment with Liraglutide Early after Surgical Intervention on Clinical Outcomes in Patients with Short Bowel Syndrome: A Pilot Observational “Real-Life” Study

The Czech Home Parenteral Nutrition Registry REDNUP: Comprehensive Analysis of Adult Patients’ Data

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