Plasma citrulline is a marker of absorptive small bowel length in patients with transient enterostomy and acute intestinal failure

Picot, D.; Garin, L.; Trivin, F.; Kossovsky, Michel P.; Thibault, Ronan

doi:10.1016/j.clnu.2009.08.010

Cited by 34 publications

(41 citation statements)

References 28 publications

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“…122 In an observational study of 57 patients, a plasma citrulline level of <20 lmol/L predicted the development of permanent IF with a sensitivity of 92% and specificity of 90%. 122,123 A retrospective European study assessing 124 patients receiving HPN demonstrated that the probability of weaning patients from HPN is <6% if not successfully undertaken in the first 2 years following the last digestive tract modification, ostensibly because the chance of intestinal adaptation thereafter is minimal. 46 Current work evaluating the role of trophic factors aimed at promoting intestinal adaptation that holds some promise; these include both nutrient (e.g.…”

Section: Outcome Of Long-term Pnmentioning

confidence: 99%

Review article: the management of long‐term parenteral nutrition

Dibb

Teubner

Theis

et al. 2013

Aliment Pharmacol Ther

137

108

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SummaryBackgroundHome parenteral nutrition (HPN) is currently the management of choice for patients with chronic intestinal failure.AimTo summarise the major issues in delivering long‐term parenteral nutrition (>3 months) and assess outcome as per complications, mortality and quality of life. To assess the evidence for the therapeutic use of trophic factors such as teduglutide and to review evolving therapeutic options in the treatment of chronic intestinal failure.MethodsA literature search using PubMed and MEDLINE databases was performed.ResultsSafe delivery of HPN relies upon individualised formulations of parenteral nutrition administered via carefully maintained central venous catheters by trained patients or carers, supported by a skilled multidisciplinary team. Early diagnosis and treatment of complications including catheter‐associated blood stream infection (reported incidence 0.14–0.83 episodes/patient‐year on HPN) and central venous thrombosis (reported incidence 0.03 episodes/patient‐year) is important to minimise mortality and morbidity. There is a significant variation in the reported incidence of both hepatobiliary complications (19–75%) and advanced liver disease (0–50%). Five‐year survival rates in large centres are reported between 60% and 78% with survival primarily related to underlying diagnosis. Long‐term survival remains higher on HPN than with intestinal transplantation. The role of intestinal lengthening procedures is yet to be validated in adults.ConclusionsHome parenteral nutrition delivered by skilled nutrition teams has low incidences of catheter‐related complications. Most deaths relate to the underlying disease. Therapies such as teduglutide and small bowel transplantation appear promising, but home parenteral nutrition appears likely to remain the bedrock of management in the near term.

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Section: Outcome Of Long-term Pnmentioning

confidence: 99%

Review article: the management of long‐term parenteral nutrition

Dibb

Teubner

Theis

et al. 2013

Aliment Pharmacol Ther

137

108

View full text Add to dashboard Cite

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“…In neonates and premature infants with double enterostomies, CR reduces PN dependence and and corrects plasma liver tests abnormalities [9]. CR improved nutritional status [4,6,7]. The larger monocentric (Clinique Saint Yves, Rennes, France) prospective cohort assessing the efficacy of CR in 212 patients with a temporary double enterostomy (86% of patients) or ECF (14%) waiting for SIRC is under publication and confirms these findings, and suggests the feasibility of home CR [4].…”

Section: Clinical Benefits Of Cr and Enteroclysismentioning

confidence: 69%

“…These studies are monocentric case series, having included only a low number of patients, and did not report post-SIRC clinical outcomes. In adult patients, CR could restore intestinal absorptive capacities [4,7]. This could allow PN discontinuation a few days after its initiation [4,5], and the improvement of frequently observed liver tests abnormalities [4].…”

Section: Clinical Benefits Of Cr and Enteroclysismentioning

confidence: 99%

“…The latter was first suggested by Levy et al [12] who showed that proximal stoma output was brake down by hydration solution enteroclysis into the downstream small bowel (-20%) and mainly by CR (-33%). Plasma citrulline normalization is the result of the increase in the functional enterocyte mass and of the better extraction of intraluminal glutamine [7]. In case of terminal ileum resection, the enterohepatic cycle of bile acids is disrupted leading to bile salts malabsorption.…”

Section: Hypotheses Upon the Mechanisms Of The Clinical Benefits Of Cmentioning

confidence: 99%

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Chyme reinfusion or enteroclysis in nutrition of patients with temporary double enterostomy or enterocutaneous fistula

Thibault

Picot

2016

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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“…Decreased plasma citrulline concentration correlates with reduced enterocyte mass in short bowel syndrome, villous atrophy states, and during follow‐up of patients after small bowel transplantation . Various cut‐offs are employed in humans to quantify the degree of intestinal failure and are useful in predicting prognosis where there is intestinal compromise …”

Section: Introductionmentioning

confidence: 99%

Determining optimal therapy of dogs with chronic enteropathy by measurement of serum citrulline

Gerou-Ferriani¹,

Allen

Noble

et al. 2018

Veterinary Internal Medicne

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BackgroundSerum concentration of citrulline is a useful biomarker in human intestinal disease and indicates globally reduced enterocyte mass and absorptive function in various disease states.ObjectivesTo determine whether serum citrulline concentration is a biomarker in chronic enteropathy (CE) in dogs, to provide useful information regarding optimal treatment or to predict outcome.AnimalsSeventy‐four dogs with CE and 83 breed‐ and age‐matched hospital controls with no clinical signs of intestinal disease.MethodsRetrospective study. Outcome was determined and dogs were categorized by response to treatment as having food‐responsive enteropathy (FRE), antibiotic‐responsive diarrhea (ARD), or idiopathic inflammatory bowel disease (IBD). Disease severity was quantified by the CIBDAI scoring index.ResultsSerum citrulline concentration did not differ between dogs with CE (median, 8.4 µg/mL, 5th‐95th percentile 2.0‐19.6) and controls (median, 8.1 µg/mL, 5th‐95th percentile 2.2‐19.7, P = .91). Serum citrulline concentration was similar between dogs with FRE (median, 9.1 µg/mL, 5th‐95th percentile 2.0‐18.9), ARD (median, 13.0 µg/mL, 5th‐95th percentile 1.6‐19.2), IBD (median, 8.4 µg/mL, 5th‐95th percentile 2.1‐21.0; P = .91). Serum citrulline did not correlate to CIBDAI or to serum albumin concentration.Conclusions and Clinical ImportanceIn our study, serum citrulline concentration was not associated with efficacy of treatment or outcome in dogs with CE.

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Plasma citrulline is a marker of absorptive small bowel length in patients with transient enterostomy and acute intestinal failure

Cited by 34 publications

References 28 publications

Review article: the management of long‐term parenteral nutrition

Review article: the management of long‐term parenteral nutrition

Chyme reinfusion or enteroclysis in nutrition of patients with temporary double enterostomy or enterocutaneous fistula

Determining optimal therapy of dogs with chronic enteropathy by measurement of serum citrulline

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