Nutritional management of a complicated surgical patient by means of fistuloclysis

Toit, Anna-Lena du

doi:10.1080/16070658.2014.11734515

Cited by 5 publications

(16 citation statements)

References 20 publications

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“…15,20,23,27 For the 2 texts describing proximally located DES, the majority of patients had their proximal DES limb <120 cm from the duodenojejunal flexure. 20,23 Likewise, specific contraindication(s) to CR were outlined in 7 articles, 10,11,13,15,21,23,28 with 3 studies reporting multiple reasons for patients not being reinfused. 10,11,15 The most common reason for selecting to omit reinfusion was an inadequate length of distal bowel or the presence of a distal bowel stenosis or obstruction (n = 10), followed by complex DES or EAF anatomy (n = 9), and an intolerance to or technical difficulties with CR (n = 9 and n = 5, respectively).…”

Section: Population Descriptorsmentioning

confidence: 99%

“…The most commonly reported technical issues with CR included backflow of effluent, effluent losses during the process of collection and storage, and tube blockage. 11,13,20,23,36 Tube blockage was a problem, with Foley catheters often being employed, leading many investigators to strain contents prior to reinfusion to prevent blockage at the outlet holes. 15,18,20,[27][28][29]36,37 Wu et al also raised the potential for tube dislodgment, eventually leading to underfeeding.…”

Section: Technical Issuesmentioning

confidence: 99%

“…Patients with intractable high outputs may require periods of nil per mouth, intravenous fluid therapy, medications to slow transit and reduce secretions, and potentially prolonged periods of support with parenteral nutrition (PN) . PN is associated with substantial economic costs as well as potential secondary complications including liver dysfunction, central line–related complications, and metabolic complications such as hyperglycemia . Alternative or an adjunctive approach to the management of these patients is desirable.…”

Section: Introductionmentioning

confidence: 99%

“…5,9 PN is associated with substantial economic costs as well as potential secondary complications including liver dysfunction, central linerelated complications, and metabolic complications such as hyperglycemia. [10][11][12][13][14] Alternative or an adjunctive approach to the management of these patients is desirable.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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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.

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Section: Population Descriptorsmentioning

confidence: 99%

Section: Technical Issuesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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“…A general description of the management of fistulas was provided in a recent case study discussion. 15 …”

Section: Pancreatic Fistulamentioning

confidence: 99%

Pancreas cancer with Whipple’s operation

Blaauw

2015

South African Journal of Clinical Nutrition

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ESTES guidelines: acute mesenteric ischaemia

Tilsed

Casamassima

Kurihara

et al. 2016

Eur J Trauma Emerg Surg

275

283

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PurposeAcute mesenteric ischaemia (AMI) accounts for about 1:1000 acute hospital admissions. Untreated, AMI will cause mesenteric infarction, intestinal necrosis, an overwhelming inflammatory response and death. Early intervention can halt and reverse this process leading to a full recovery, but the diagnosis of AMI is difficult and failure to recognize AMI before intestinal necrosis has developed is responsible for the high mortality of the disease. Early diagnosis and prompt treatment are the goals of modern therapy, but there are no randomized controlled trials to guide treatment and the published literature contains a high ratio of reviews to original data. Much of that data comes from case reports and often small, retrospective series with no clearly defined treatment criteria.MethodsA study group of the European Society for Trauma and Emergency Surgery (ESTES) was formed in 2013 with the aim of developing guidelines for the management of AMI. A comprehensive literature search was performed using the Medical Subject Heading (MeSH) thesaurus keywords “mesenteric ischaemia”, “bowel ischaemia” and “bowel infarction”. The bibliographies of relevant articles were screened for additional publications. After an initial systematic review of the literature by the whole group, a steering group formulated questions using a modified Delphi process. The evidence was then reviewed to answer these questions, and recommendations formulated and agreed by the whole group.ResultsThe resultant recommendations are presented in this paper.ConclusionsThe aim of these guidelines is to provide recommendations for practice that will lead to improved outcomes for patients.

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Nutritional management of a complicated surgical patient by means of fistuloclysis

Cited by 5 publications

References 20 publications

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

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

Pancreas cancer with Whipple’s operation

ESTES guidelines: acute mesenteric ischaemia

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