Pediatric Home Parenteral Nutrition in France: A six years national survey

Goulet, Olivier; Breton, A; Coste, Marie-Edith; Dubern, B.; Ecochard-Dugelay, Emmanuelle; Guimber, D.; Loras-Duclaux, I; Nader, Elie Abi; Marinier, Evelyne; Peretti, Noël; Lambe, Cécile

doi:10.1016/j.clnu.2021.08.002

Cited by 18 publications

(32 citation statements)

References 82 publications

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“…The remaining patients used olive oil-based ILE (Clinoleic ® ). This trend is in line with other studies that reported predominant use (>80% of patients) of SMOFlipid ® ( 19 ). The use of this composite ILE, which has been shown to prevent or reverse cholestasis, is a standard of care in most European centers ( 32 ).…”

Section: Discussionsupporting

confidence: 93%

“…In this study, 3.3% of patients showed IFALD; of these, 3 ultrashort bowel patients developed IFALD before 2008, while one patient with congenital immunodeficiency evolved in IFALD due to numerous sepsis. Even if it is difficult to compare the IFALD incidence with other reports in the literature, due to a non-uniform choice of definition ( 31 ), our data is in line with what was reported by Olivier Goulet et al ( 19 ). Several reasons may explain our low rate of IFALD, HPN standard of care being the most important one in our opinion: HPN and global IF multidisciplinary management by certified centers led to similar scenarios in our region and in France.…”

Section: Discussionsupporting

confidence: 91%

“…That is the reason why the taurolidine lock procedure was one of the most relevant breakthroughs in the management of HPN in pediatric patients over the last few years ( 27 , 28 ), with a reported decrease in CRBSI rate from 8.6 to 1.1 episodes per 1,000 days of PN ( 29 ). We observed a trend of reduction in the CRBSI rate between the first and the second decade of the study period ( Figure 3 ), possibly due to the increase in the number of patients using taurolidine CVC locks, as reported in other recent studies ( 19 ). However, the overall infection rate in our sample was minimal (0.33 episodes/1,000 catheter days), suggesting that, even if Tauro-lock procedure is an important tool, HPN management should be based on a high-quality formal training of the caregivers as well as on the use of the most recent line connectors and tools.…”

Section: Discussionsupporting

confidence: 81%

“…On the other hand, similar trends are reported in the United Kingdom, where the prevalence of CIF has risen from 4.4/million in 1993 to 13.9/million in 2010 and 16.6/million at risk in 2012. Also, Goulet et al reported a 43.7% increase in the number of children and adolescents enrolled in HPN programs in France over the 5 years of their study period ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

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HPN Standard of Care and Long-Term Outcomes of CIF Pediatric Patients: Twenty-Eight Years' Experience in a Reference Center

et al. 2022

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Background and AimsChronic intestinal failure (CIF) therapy changed significantly in recent decades, and both survival and complication rates improved over time. International guidelines claim that early referral of long-term home parenteral nutrition (HPN) patients to an expert center with specific standards of care may positively affect long-term outcomes. Herein, we retrospectively analyse the long-term outcomes of a cohort of pediatric patients with CIF followed-up since our Pediatric Intestinal Failure Unit foundation, in 1989.MethodsData of the 120 children followed up at Pediatric Intestinal Failure Unit during the last 28 years were retrospectively collected. Patients' and HPN characteristics, as well as dependence, survival, and complication rates, were described.ResultsIncidence and prevalence of CIF increased during the study period particularly due to the increase of HPN for non-digestive disease (NDD) CIF (47.5% of the study sample). Catheter-related bloodstream infection (CRBSI) rate decreased over the study period: 0.33 episodes/1,000 catheters days before 2011 and 0.19 episodes/1,000 catheters days afterwards. Only 1 patient out of 12 died because of HPN complications. The survival rate of patients with PDD was 98.4% at 1 year from the beginning of HPN, 96.5% at 2 years, and 93.8% from the fifth year onwards. Concerning the dependence rate, 70.6% of patients were still on HPN 1 year after the start of HPN, 63.7% at 2 years, 52.4% at 5 years, and 40.8% from the 9th year onwards, with no significant difference according to the underlying intestinal pathology. The survival rate of NDD patients was 91.2% at 1 year from the beginning of HPN, 87.4% at 2 years, and 81.9% from the third year onwards. For what concerns the enteral autonomy, it was regained by 56.7% 1 year after the start of HPN, 74.5% at 2 years, and 95.0% in the 5th year.ConclusionsOur data confirmed the importance of appropriate standards of care and suggest that applying a specific set of standards and protocols may further improve patients' outcomes and survival. Indeed, both primary and non-digestive diseases HPN showed good outcomes.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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HPN Standard of Care and Long-Term Outcomes of CIF Pediatric Patients: Twenty-Eight Years' Experience in a Reference Center

et al. 2022

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“…The use of Taurolidine to treat surgical infection in the operation room was first described in some anecdotal reports in the 1980s. Subsequently, Taurolidine has been most commonly used in locking solutions to prevent catheter-related bloodstream infection in fragile patients [4][5][6]. As far as we are aware, Taurolidine has not been used to treat a VAD driveline infection before.…”

Section: Discussionmentioning

confidence: 99%

Eradication of Ventricular Assist Device Driveline Infection in Paediatric Patients with Taurolidine

Weichsel

Baldauf

Bonnemeier

et al. 2022

JCDD

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Ventricular assist devices (VADs) are used to provide mechanical circulatory support to patients with end-stage heart failure. The driveline connecting the external power source to the pump(s) of the intra-corporal VAD breaches the protective skin barrier and provides a track for microbes to invade the interior of the patient’s body. Driveline infection constitutes a major and potentially fatal vulnerability of VAD therapy. Driveline infection cannot traditionally be salvaged and requires the extraction of the entire VAD system. We report here the successful eradication of a VAD driveline infection with a taurolidine-containing antimicrobial solution used for preventing the infection of cardiac implantable electronic devices. If replicated in more cases, the novel treatment concept described here may provide a valuable alternative management strategy of salvage rather than explantation for VAD driveline infection.

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Development of a core outcome set for pediatric chronic intestinal failure

Demirok

Nagelkerke

Benninga

et al. 2023

J Parenter Enteral Nutr

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Background: In research on pediatric chronic intestinal failure, heterogeneity in reported definitions and outcomes exists. This leads to a risk of reporting bias and impossibility of evidence synthesis. Also, reported outcomes should be relevant to both healthcare providers and patients and their parents. Therefore, the aim of this study is to create a core outcome set (COS) to be used in studies on pediatric chronic intestinal failure.Methods: Candidate outcomes were selected from a recent systematic review.A three-round Delphi study among key stakeholders and a consensus meeting with an expert panel were undertaken to achieve consensus on the COS.Results: Seventy-two stakeholders (79%) completed all three rounds of the Delphi process. Ninety-eight outcomes were assessed, and five new outcomes were added

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Pediatric Home Parenteral Nutrition in France: A six years national survey

Cited by 18 publications

References 82 publications

HPN Standard of Care and Long-Term Outcomes of CIF Pediatric Patients: Twenty-Eight Years' Experience in a Reference Center

HPN Standard of Care and Long-Term Outcomes of CIF Pediatric Patients: Twenty-Eight Years' Experience in a Reference Center

Eradication of Ventricular Assist Device Driveline Infection in Paediatric Patients with Taurolidine

Development of a core outcome set for pediatric chronic intestinal failure

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