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1. Management of acute mesenteric ischaemia: Results of a worldwide survey

Author

Hess, B, Cahenzli, M, Forbes, A, Burgos, R, Coccolini, F, Corcos, O, Holst, M, Irtun, Ø, Klek, S, Pironi, L, Rasmussen, H, Serlie, M, Thibault, R, Gabe, S, Reintam Blaser, A, Akin, E, Ali, S, Argenio, G, Atici, S, Augustin, G, Baili, E, Bains, L, Bala, M, Baldini, E, Baraket, O, Barone, M, Biloslavo, A, Roberto, B, Bombardini, C, Brisinda, G, Buonomo, L, Catena, F, Ceresoli, M, Chiarello, M, Chouliaras, C, D'Acapito, F, Damaskos, D, De Simone, B, Delogu, D, Demetrashvili, Z, Di Carlo, I, D'Oria, M, Durán-Muñoz-Cruzado, V, Forget, P, Fortuna, L, Fransvea, P, Frey, C, Gapejeva, O, Garcon, P, Gass, J, Teixeira Gonsaga, R, Griffiths, E, Gundogan, K, Gurjar, M, Hamid, H, Silesky Jiménez, J, Kase, K, Hussain Kazmi, S, Kechagias, A, Khokha, V, Kobe, Y, Korkolis, D, Litvin, A, Lostoridis, E, Mahendran, H, Marino, F, Martinuzzi, A, Mesina, C, Neri, V, Panisic, M, Paolillo, C, Pararas, N, Perrone, G, Pesce, A, Picardi, B, Pither, C, Podda, M, Poskus, T, Poullenot, F, Przemyslaw, M, Sartelli, M, Sasia, D, Scheiterle, M, Seretis, F, Søreide, K, Sydorchuk, R, Szczepanek, K, Bodnar, Z, Tamion, F, Tarasconi, A, Teraa, M, Tolonen, M, Vanuytsel, T, Veroux, M, Vinter-Jensen, L, Visconti, D, Widmer, L, Zakaria, A, Zubareva, N, Endorsing International, S, Hess B., Cahenzli M., Forbes A., Burgos R., Coccolini F., Corcos O., Holst M., Irtun Ø., Klek S., Pironi L., Rasmussen H. H., Serlie M. J., Thibault R., Gabe S., Reintam Blaser A., Akin E., Ali S. M., Argenio G., Atici S. D., Augustin G., Baili E., Bains L., Bala M., Baldini E., Baraket O., Barone M., Biloslavo A., Roberto Bini, Bombardini C., Brisinda G., Buonomo L., Catena F., Ceresoli M., Chiarello M. M., Chouliaras C., D'Acapito F., Damaskos D., De Simone B., Delogu D., Demetrashvili Z., Di Carlo I., D'Oria M., Durán-Muñoz-Cruzado V. M., Forget P., Fortuna L., Fransvea P., Frey C., Gapejeva O., Garcon P., Gass J. M., Teixeira Gonsaga R. A., Griffiths E., Gundogan K., Gurjar M., Hamid H. K. S., Silesky Jiménez J. I., Kase K., Hussain Kazmi S. S., Kechagias A., Khokha V., Kobe Y., Korkolis D. P., Litvin A., Lostoridis E., Mahendran H. A., Marino F., Martinuzzi A., Mesina C., Neri V., Panisic M., Paolillo C., Pararas N., Perrone G., Pesce A., Picardi B., Pither C., Podda M., Poskus T., Poullenot F., Przemyslaw M., Sartelli M., Sasia D., Scheiterle M., Seretis F., Søreide K., Sydorchuk R., Szczepanek K., Bodnar Z., Tamion F., Tarasconi A., Teraa M., Tolonen M., Vanuytsel T., Veroux M., Vinter-Jensen L., Visconti D., Widmer L., Zakaria A. D., Zubareva N., Endorsing International Societies, Hess, B, Cahenzli, M, Forbes, A, Burgos, R, Coccolini, F, Corcos, O, Holst, M, Irtun, Ø, Klek, S, Pironi, L, Rasmussen, H, Serlie, M, Thibault, R, Gabe, S, Reintam Blaser, A, Akin, E, Ali, S, Argenio, G, Atici, S, Augustin, G, Baili, E, Bains, L, Bala, M, Baldini, E, Baraket, O, Barone, M, Biloslavo, A, Roberto, B, Bombardini, C, Brisinda, G, Buonomo, L, Catena, F, Ceresoli, M, Chiarello, M, Chouliaras, C, D'Acapito, F, Damaskos, D, De Simone, B, Delogu, D, Demetrashvili, Z, Di Carlo, I, D'Oria, M, Durán-Muñoz-Cruzado, V, Forget, P, Fortuna, L, Fransvea, P, Frey, C, Gapejeva, O, Garcon, P, Gass, J, Teixeira Gonsaga, R, Griffiths, E, Gundogan, K, Gurjar, M, Hamid, H, Silesky Jiménez, J, Kase, K, Hussain Kazmi, S, Kechagias, A, Khokha, V, Kobe, Y, Korkolis, D, Litvin, A, Lostoridis, E, Mahendran, H, Marino, F, Martinuzzi, A, Mesina, C, Neri, V, Panisic, M, Paolillo, C, Pararas, N, Perrone, G, Pesce, A, Picardi, B, Pither, C, Podda, M, Poskus, T, Poullenot, F, Przemyslaw, M, Sartelli, M, Sasia, D, Scheiterle, M, Seretis, F, Søreide, K, Sydorchuk, R, Szczepanek, K, Bodnar, Z, Tamion, F, Tarasconi, A, Teraa, M, Tolonen, M, Vanuytsel, T, Veroux, M, Vinter-Jensen, L, Visconti, D, Widmer, L, Zakaria, A, Zubareva, N, Endorsing International, S, Hess B., Cahenzli M., Forbes A., Burgos R., Coccolini F., Corcos O., Holst M., Irtun Ø., Klek S., Pironi L., Rasmussen H. H., Serlie M. J., Thibault R., Gabe S., Reintam Blaser A., Akin E., Ali S. M., Argenio G., Atici S. D., Augustin G., Baili E., Bains L., Bala M., Baldini E., Baraket O., Barone M., Biloslavo A., Roberto Bini, Bombardini C., Brisinda G., Buonomo L., Catena F., Ceresoli M., Chiarello M. M., Chouliaras C., D'Acapito F., Damaskos D., De Simone B., Delogu D., Demetrashvili Z., Di Carlo I., D'Oria M., Durán-Muñoz-Cruzado V. M., Forget P., Fortuna L., Fransvea P., Frey C., Gapejeva O., Garcon P., Gass J. M., Teixeira Gonsaga R. A., Griffiths E., Gundogan K., Gurjar M., Hamid H. K. S., Silesky Jiménez J. I., Kase K., Hussain Kazmi S. S., Kechagias A., Khokha V., Kobe Y., Korkolis D. P., Litvin A., Lostoridis E., Mahendran H. A., Marino F., Martinuzzi A., Mesina C., Neri V., Panisic M., Paolillo C., Pararas N., Perrone G., Pesce A., Picardi B., Pither C., Podda M., Poskus T., Poullenot F., Przemyslaw M., Sartelli M., Sasia D., Scheiterle M., Seretis F., Søreide K., Sydorchuk R., Szczepanek K., Bodnar Z., Tamion F., Tarasconi A., Teraa M., Tolonen M., Vanuytsel T., Veroux M., Vinter-Jensen L., Visconti D., Widmer L., Zakaria A. D., Zubareva N., and Endorsing International Societies

Abstract

Background: Acute mesenteric ischaemia (AMI) is a condition with high mortality. This survey assesses current attitudes and practices to manage AMI worldwide. Methods: A questionnaire survey about the practices of diagnosing and managing AMI, endorsed by several specialist societies, was sent to different medical specialists and hospitals worldwide. Data from individual health care professionals and from medical teams were collected. Results: We collected 493 individual forms from 71 countries and 94 team forms from 34 countries. Almost half of respondents were surgeons, and most of the responding teams (70%) were led by surgeons. Most of the respondents indicated that diagnosis of AMI is often delayed but rarely missed. Emergency revascularisation is often considered for patients with AMI but rarely in cases of transmural ischaemia (intestinal infarction). Responses from team hospitals with a dedicated special unit (14 team forms) indicated more aggressive revascularisation. Abdominopelvic CT-scan with intravenous contrast was suggested as the most useful diagnostic test, indicated by approximately 90% of respondents. Medical history and risk factors were thought to be more important in diagnosis of AMI without transmural ischaemia, whereas for intestinal infarction, plasma lactate concentrations and surgical exploration were considered more useful. In elderly patients, a palliative approach is often chosen over extensive bowel resection. There was a large variability in anticoagulant treatment, as well as in timing of surgery to restore bowel continuity. Conclusions: Delayed diagnosis of AMI is common despite wide availability of an adequate imaging modality, i.e. CT-scan. Large variability in treatment approaches exists, indicating the need for updated guidelines. Increased awareness and knowledge of AMI may improve current practice until more robust evidence becomes available. Adherence to the existing guidelines may help in improving differences in treatment an

Published
2023

2. COVID-19 infection in patients on long-term home parenteral nutrition for chronic intestinal failure

Author

Pironi, L, Jezerski, D, Sobocki, J, Lal, S, Vanuytsel, T, Theilla, M, Sasdelli, A, Chambrier, C, Matysiak, K, Aimasso, U, Rasmussen, H, Jukes, A, Kunecki, M, Seguy, D, Schneider, S, Daniels, J, Poullenot, F, Mundi, M, Matras, P, Folwarski, M, Crivelli, A, Wyer, N, Ellegard, L, Santarpia, L, Arvanitakis, M, Spaggiari, C, Lamprecht, G, Guglielmi, F, Lezo, A, Layec, S, Boluda, E, Guz-Mark, A, Gandullia, P, Cuerda, C, Osland, E, Spagnuolo, M, Krznaric, Z, Masconale, L, Chapman, B, Maiz-Jimenez, M, Orlandoni, P, Martins da Rocha, M, Virgili-Casas, M, Doitchinova-Simeonova, M, Czako, L, Van Gossum, A, D'Antiga, L, Ee, L, Warodomwichit, D, Taus, M, Kolacek, S, Thibault, R, Verlato, G, Serralde-Zuniga, A, Botella-Carretero, J, Aguayo, P, Olveira, G, Chomtho, S, Pisprasert, V, Moisejevs, G, Murillo, A, Jauregui, M, Diez, M, Jahit, M, Densupsoontorn, N, Tamer, A, Brillanti, G, Joly, F, Pironi L., Jezerski D., Sobocki J., Lal S., Vanuytsel T., Theilla M., Sasdelli A. S., Chambrier C., Matysiak K., Aimasso U., Rasmussen H. H., Jukes A., Kunecki M., Seguy D., Schneider S. M., Daniels J., Poullenot F., Mundi M. S., Matras P., Folwarski M., Crivelli A., Wyer N., Ellegard L., Santarpia L., Arvanitakis M., Spaggiari C., Lamprecht G., Guglielmi F. W., Lezo A., Layec S., Boluda E. R., Guz-Mark A., Gandullia P., Cuerda C., Osland E., Spagnuolo M. I., Krznaric Z., Masconale L., Chapman B., Maiz-Jimenez M., Orlandoni P., Martins da Rocha M. H., Virgili-Casas M. N., Doitchinova-Simeonova M., Czako L., Van Gossum A., D'Antiga L., Ee L. C., Warodomwichit D., Taus M., Kolacek S., Thibault R., Verlato G., Serralde-Zuniga A. E., Botella-Carretero J. I., Aguayo P. S., Olveira G., Chomtho S., Pisprasert V., Moisejevs G., Murillo A. Z., Jauregui M. E. P., Diez M. B., Jahit M. S., Densupsoontorn N., Tamer A., Brillanti G., Joly F., Pironi, L, Jezerski, D, Sobocki, J, Lal, S, Vanuytsel, T, Theilla, M, Sasdelli, A, Chambrier, C, Matysiak, K, Aimasso, U, Rasmussen, H, Jukes, A, Kunecki, M, Seguy, D, Schneider, S, Daniels, J, Poullenot, F, Mundi, M, Matras, P, Folwarski, M, Crivelli, A, Wyer, N, Ellegard, L, Santarpia, L, Arvanitakis, M, Spaggiari, C, Lamprecht, G, Guglielmi, F, Lezo, A, Layec, S, Boluda, E, Guz-Mark, A, Gandullia, P, Cuerda, C, Osland, E, Spagnuolo, M, Krznaric, Z, Masconale, L, Chapman, B, Maiz-Jimenez, M, Orlandoni, P, Martins da Rocha, M, Virgili-Casas, M, Doitchinova-Simeonova, M, Czako, L, Van Gossum, A, D'Antiga, L, Ee, L, Warodomwichit, D, Taus, M, Kolacek, S, Thibault, R, Verlato, G, Serralde-Zuniga, A, Botella-Carretero, J, Aguayo, P, Olveira, G, Chomtho, S, Pisprasert, V, Moisejevs, G, Murillo, A, Jauregui, M, Diez, M, Jahit, M, Densupsoontorn, N, Tamer, A, Brillanti, G, Joly, F, Pironi L., Jezerski D., Sobocki J., Lal S., Vanuytsel T., Theilla M., Sasdelli A. S., Chambrier C., Matysiak K., Aimasso U., Rasmussen H. H., Jukes A., Kunecki M., Seguy D., Schneider S. M., Daniels J., Poullenot F., Mundi M. S., Matras P., Folwarski M., Crivelli A., Wyer N., Ellegard L., Santarpia L., Arvanitakis M., Spaggiari C., Lamprecht G., Guglielmi F. W., Lezo A., Layec S., Boluda E. R., Guz-Mark A., Gandullia P., Cuerda C., Osland E., Spagnuolo M. I., Krznaric Z., Masconale L., Chapman B., Maiz-Jimenez M., Orlandoni P., Martins da Rocha M. H., Virgili-Casas M. N., Doitchinova-Simeonova M., Czako L., Van Gossum A., D'Antiga L., Ee L. C., Warodomwichit D., Taus M., Kolacek S., Thibault R., Verlato G., Serralde-Zuniga A. E., Botella-Carretero J. I., Aguayo P. S., Olveira G., Chomtho S., Pisprasert V., Moisejevs G., Murillo A. Z., Jauregui M. E. P., Diez M. B., Jahit M. S., Densupsoontorn N., Tamer A., Brillanti G., and Joly F.

Abstract

Background and aims: To investigate the incidence and the severity of COVID-19 infection in patients enrolled in the database for home parenteral nutrition (HPN) for chronic intestinal failure (CIF) of the European Society for Clinical Nutrition and Metabolism (ESPEN). Methods: Period of observation: March 1st, 2020 March 1st, 2021. Inclusion criteria: patients included in the database since 2015 and still receiving HPN on March 1st, 2020 as well as new patients included in the database during the period of observation. Data related to the previous 12 months and recorded on March 1st 2021: 1) occurrence of COVID-19 infection since the beginning of the pandemic (yes, no, unknown); 2) infection severity (asymptomatic; mild, no-hospitalization; moderate, hospitalization no-ICU; severe, hospitalization in ICU); 3) vaccinated against COVID-19 (yes, no, unknown); 4) patient outcome on March 1st 2021: still on HPN, weaned off HPN, deceased, lost to follow up. Results: Sixty-eight centres from 23 countries included 4680 patients. Data on COVID-19 were available for 55.1% of patients. The cumulative incidence of infection was 9.6% in the total group and ranged from 0% to 21.9% in the cohorts of individual countries. Infection severity was reported as: asymptomatic 26.7%, mild 32.0%, moderate 36.0%, severe 5.3%. Vaccination status was unknown in 62.0% of patients, non-vaccinated 25.2%, vaccinated 12.8%. Patient outcome was reported as: still on HPN 78.6%, weaned off HPN 10.6%, deceased 9.7%, lost to follow up 1.1%. A higher incidence of infection (p = 0.04), greater severity of infection (p < 0.001) and a lower vaccination percentage (p = 0.01) were observed in deceased patients. In COVID-19 infected patients, deaths due to infection accounted for 42.8% of total deaths. Conclusions: In patients on HPN for CIF, the incidence of COVID-19 infection differed greatly among countries. Although the majority of cases were reported to be asymptomatic or have mild symptoms only, COV

Published
2023

3. Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey

Author

Pironi, L, Steiger, E., Joly, F., Jeppesen, P.B., Wanten, G.J.A., Sasdelli, A.S., Chambrier, C., Aimasso, U., Mundi, M.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Santarpia, L., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Ellegard, L., Thibault, R., Matras, P., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Udvarhelyi, G., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Spaggiari, C., Díez, M.B., Doitchinova-Simeonova, M., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, M.E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Youssef, N.N., Brillanti, G., Nardi, E., Lal, S., Pironi, L, Steiger, E., Joly, F., Jeppesen, P.B., Wanten, G.J.A., Sasdelli, A.S., Chambrier, C., Aimasso, U., Mundi, M.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Santarpia, L., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Ellegard, L., Thibault, R., Matras, P., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Udvarhelyi, G., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Spaggiari, C., Díez, M.B., Doitchinova-Simeonova, M., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, M.E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Youssef, N.N., Brillanti, G., Nardi, E., and Lal, S.

Abstract

Item does not contain fulltext, BACKGROUND AND AIMS: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. METHODS: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as <1, 1-2, 2-3 and >3 L/day. RESULTS: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. CONCLUSIONS: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.

Published
2021

4. Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey.

Author

Pironi, L, Steiger, E, Joly, F, Jeppesen, PB, Wanten, G, Sasdelli, AS, Chambrier, C, Aimasso, U, Mundi, MS, Szczepanek, K, Jukes, A, Theilla, M, Kunecki, M, Daniels, J, Serlie, M, Poullenot, F, Cooper, SC, Rasmussen, HH, Compher, C, Seguy, D, Crivelli, A, Santarpia, L, Guglielmi, FW, Kozjek, NR, Schneider, SM, Ellegard, L, Thibault, R, Matras, P, Matysiak, K, Van Gossum, A, Forbes, A, Wyer, N, Taus, M, Virgili, NM, O'Callaghan, M, Chapman, B, Osland, E, Cuerda, C, Udvarhelyi, G, Jones, L, Won Lee, AD, Masconale, L, Orlandoni, P, Spaggiari, C, Díez, MB, Doitchinova-Simeonova, M, Serralde-Zúñiga, AE, Olveira, G, Krznaric, Z, Czako, L, Kekstas, G, Sanz-Paris, A, Jáuregui, MEP, Murillo, AZ, Schafer, E, Arends, J, Suárez-Llanos, JP, Youssef, NN, Brillanti, G, Nardi, E, Lal, S, Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN, European Society for Clinical Nutrition and Metabolism, Pironi, L, Steiger, E, Joly, F, Jeppesen, PB, Wanten, G, Sasdelli, AS, Chambrier, C, Aimasso, U, Mundi, MS, Szczepanek, K, Jukes, A, Theilla, M, Kunecki, M, Daniels, J, Serlie, M, Poullenot, F, Cooper, SC, Rasmussen, HH, Compher, C, Seguy, D, Crivelli, A, Santarpia, L, Guglielmi, FW, Kozjek, NR, Schneider, SM, Ellegard, L, Thibault, R, Matras, P, Matysiak, K, Van Gossum, A, Forbes, A, Wyer, N, Taus, M, Virgili, NM, O'Callaghan, M, Chapman, B, Osland, E, Cuerda, C, Udvarhelyi, G, Jones, L, Won Lee, AD, Masconale, L, Orlandoni, P, Spaggiari, C, Díez, MB, Doitchinova-Simeonova, M, Serralde-Zúñiga, AE, Olveira, G, Krznaric, Z, Czako, L, Kekstas, G, Sanz-Paris, A, Jáuregui, MEP, Murillo, AZ, Schafer, E, Arends, J, Suárez-Llanos, JP, Youssef, NN, Brillanti, G, Nardi, E, Lal, S, Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN, and European Society for Clinical Nutrition and Metabolism

Abstract

BACKGROUND AND AIMS: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. METHODS: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as <1, 1-2, 2-3 and >3 L/day. RESULTS: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. CONCLUSIONS: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.

Published
2021

5. Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey

Author

Pironi, L, Steiger, E., Joly, F., Jeppesen, P.B., Wanten, G.J.A., Sasdelli, A.S., Chambrier, C., Aimasso, U., Mundi, M.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Santarpia, L., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Ellegard, L., Thibault, R., Matras, P., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Udvarhelyi, G., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Spaggiari, C., Díez, M.B., Doitchinova-Simeonova, M., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, M.E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Youssef, N.N., Brillanti, G., Nardi, E., Lal, S., Pironi, L, Steiger, E., Joly, F., Jeppesen, P.B., Wanten, G.J.A., Sasdelli, A.S., Chambrier, C., Aimasso, U., Mundi, M.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Santarpia, L., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Ellegard, L., Thibault, R., Matras, P., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Udvarhelyi, G., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Spaggiari, C., Díez, M.B., Doitchinova-Simeonova, M., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, M.E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Youssef, N.N., Brillanti, G., Nardi, E., and Lal, S.

Abstract

Contains fulltext : 244566.pdf (Publisher’s version ) (Closed access), BACKGROUND AND AIMS: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. METHODS: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as <1, 1-2, 2-3 and >3 L/day. RESULTS: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. CONCLUSIONS: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.

Published
2021

6. Characteristics of adult patients with chronic intestinal failure due to short bowel syndrome: An international multicenter survey

Author

Pironi, L, Steiger, E., Joly, F., Jeppesen, P.B., Wanten, G.J.A., Sasdelli, A.S., Chambrier, C., Aimasso, U., Mundi, M.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Santarpia, L., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Ellegard, L., Thibault, R., Matras, P., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Udvarhelyi, G., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Spaggiari, C., Díez, M.B., Doitchinova-Simeonova, M., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, M.E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Youssef, N.N., Brillanti, G., Nardi, E., Lal, S., Pironi, L, Steiger, E., Joly, F., Jeppesen, P.B., Wanten, G.J.A., Sasdelli, A.S., Chambrier, C., Aimasso, U., Mundi, M.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Santarpia, L., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Ellegard, L., Thibault, R., Matras, P., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Udvarhelyi, G., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Spaggiari, C., Díez, M.B., Doitchinova-Simeonova, M., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, M.E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Youssef, N.N., Brillanti, G., Nardi, E., and Lal, S.

Abstract

Contains fulltext : 244566.pdf (Publisher’s version ) (Closed access), BACKGROUND AND AIMS: The case-mix of patients with intestinal failure due to short bowel syndrome (SBS-IF) can differ among centres and may also be affected by the timeframe of data collection. Therefore, the ESPEN international multicenter cross-sectional survey was analyzed to compare the characteristics of SBS-IF cohorts collected within the same timeframe in different countries. METHODS: The study included 1880 adult SBS-IF patients collected in 2015 by 65 centres from 22 countries. The demographic, nutritional, SBS type (end jejunostomy, SBS-J; jejuno-colic anastomosis, SBS-JC; jejunoileal anastomosis with an intact colon and ileocecal valve, SBS-JIC), underlying disease and intravenous supplementation (IVS) characteristics were analyzed. IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorized as <1, 1-2, 2-3 and >3 L/day. RESULTS: In the entire group: 60.7% were females and SBS-J comprised 60% of cases, while mesenteric ischaemia (MI) and Crohn' disease (CD) were the main underlying diseases. IVS dependency was longer than 3 years in around 50% of cases; IVS was infused ≥5 days/week in 75% and FE in 10% of cases. Within the SBS-IF cohort: CD was twice and thrice more frequent in SBS-J than SBS-JC and SBS-JIC, respectively, while MI was more frequent in SBS-JC and SBS-JIC. Within countries: SBS-J represented 75% or more of patients in UK and Denmark and 50-60% in the other countries, except Poland where SBS-JC prevailed. CD was the main underlying disease in UK, USA, Denmark and The Netherlands, while MI prevailed in France, Italy and Poland. CONCLUSIONS: SBS-IF type is primarily determined by the underlying disease, with significant variation between countries. These novel data will be useful for planning and managing both clinical activity and research studies on SBS.

Published
2021

7. Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey

Author

Pironi, L, Steiger, E., Brandt, C, Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Zeraschi, S., Kelly, D., Szczepanek, K., Jukes, A., Caro, S. Di, Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Wu, J., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Pagano, M.C., Hughes, S.J., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Gillanders, L., Ellegard, L., Thibault, R., Matras, P., Zmarzly, A., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Sahin, P., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Izbéki, F., Spaggiari, C., Bueno, M., Doitchinova-Simeonova, M., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Lal, S., Pironi, L, Steiger, E., Brandt, C, Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Zeraschi, S., Kelly, D., Szczepanek, K., Jukes, A., Caro, S. Di, Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Wu, J., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Pagano, M.C., Hughes, S.J., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Gillanders, L., Ellegard, L., Thibault, R., Matras, P., Zmarzly, A., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Sahin, P., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Izbéki, F., Spaggiari, C., Bueno, M., Doitchinova-Simeonova, M., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., and Lal, S.

Abstract

Contains fulltext : 220087.pdf (Publisher’s version ) (Closed access), BACKGROUND & AIMS: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF). METHODS: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions. RESULTS: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p < 0.001). IVS-admixture comprised: FE 10%, PA 17%, PAFE 17%, CA 38%, CAFE 18%. PA and PAFE prevailed in malignant-CIF while CA and CAFE use was greater in benign-CIF (p < 0.001). PA + PAFE prevailed in those countries where LP was the main HPN-provider and CA + CAFE prevailed where the main HPN-provider was HCC (p < 0.001). CONCLUSIONS: This is the first study to demonstrate that HPN provision and the IVS-admixture differ greatly among countries, among HPN centers and between benign-CIF and cancer-CIF. As both HPN provider and IVS-admixture types may play a role in the safety and effectiveness of HPN therapy, criteria to homogenize HPN programs are needed so that patients can have equal access to optimal CIF care.

Published
2020

8. Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure

Author

Pironi, L, Steiger, E., Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M.J., Cooper, S.C., Poullenot, F., Rasmussen, H.H., Compher, C.W., Crivelli, A., Hughes, S.J., Santarpia, L., Guglielmi, F.W., Kozjek, N. Rotovnik, Ellegard, L., Schneider, S.M., Matras, P., Forbes, A., Wyer, N., Zmarzly, A., Taus, M., O'Callaghan, M., Osland, E., Thibault, R., Cuerda, C., Jones, L., Chapman, B., Sahin, P., Virgili, N.M., Lee, A.D. Won, Orlandoni, P., Matysiak, K., Caro, S. Di, Doitchinova-Simeonova, M., Masconale, L., Spaggiari, C., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Jáuregui, E. Petrina, Murillo, A., Suárez-Llanos, J.P., Nardi, E., Gossum, A. van, Lal, S., Pironi, L, Steiger, E., Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M.J., Cooper, S.C., Poullenot, F., Rasmussen, H.H., Compher, C.W., Crivelli, A., Hughes, S.J., Santarpia, L., Guglielmi, F.W., Kozjek, N. Rotovnik, Ellegard, L., Schneider, S.M., Matras, P., Forbes, A., Wyer, N., Zmarzly, A., Taus, M., O'Callaghan, M., Osland, E., Thibault, R., Cuerda, C., Jones, L., Chapman, B., Sahin, P., Virgili, N.M., Lee, A.D. Won, Orlandoni, P., Matysiak, K., Caro, S. Di, Doitchinova-Simeonova, M., Masconale, L., Spaggiari, C., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Jáuregui, E. Petrina, Murillo, A., Suárez-Llanos, J.P., Nardi, E., Gossum, A. van, and Lal, S.

Abstract

Contains fulltext : 225267.pdf (Publisher’s version ) (Closed access), BACKGROUND AND AIM: No marker to categorise the severity of chronic intestinal failure (CIF) has been developed. A 1-year international survey was carried out to investigate whether the European Society for Clinical Nutrition and Metabolism clinical classification of CIF, based on the type and volume of the intravenous supplementation (IVS), could be an indicator of CIF severity. METHODS: At baseline, participating home parenteral nutrition (HPN) centres enrolled all adults with ongoing CIF due to non-malignant disease; demographic data, body mass index, CIF mechanism, underlying disease, HPN duration and IVS category were recorded for each patient. The type of IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorised as <1, 1-2, 2-3 and >3 L/day. The severity of CIF was determined by patient outcome (still on HPN, weaned from HPN, deceased) and the occurrence of major HPN/CIF-related complications: intestinal failure-associated liver disease (IFALD), catheter-related venous thrombosis and catheter-related bloodstream infection (CRBSI). RESULTS: Fifty-one HPN centres included 2194 patients. The analysis showed that both IVS type and volume were independently associated with the odds of weaning from HPN (significantly higher for PN <1 L/day than for FE and all PN >1 L/day), patients' death (lower for FE, p=0.079), presence of IFALD cholestasis/liver failure and occurrence of CRBSI (significantly higher for PN 2-3 and PN >3 L/day). CONCLUSIONS: The type and volume of IVS required by patients with CIF could be indicators to categorise the severity of CIF in both clinical practice and research protocols.

Published
2020

9. Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey

Author

Pironi, L, Steiger, E., Brandt, C, Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Zeraschi, S., Kelly, D., Szczepanek, K., Jukes, A., Caro, S. Di, Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Wu, J., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Pagano, M.C., Hughes, S.J., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Gillanders, L., Ellegard, L., Thibault, R., Matras, P., Zmarzly, A., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Sahin, P., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Izbéki, F., Spaggiari, C., Bueno, M., Doitchinova-Simeonova, M., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Lal, S., Pironi, L, Steiger, E., Brandt, C, Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Zeraschi, S., Kelly, D., Szczepanek, K., Jukes, A., Caro, S. Di, Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Wu, J., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Pagano, M.C., Hughes, S.J., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Gillanders, L., Ellegard, L., Thibault, R., Matras, P., Zmarzly, A., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Sahin, P., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Izbéki, F., Spaggiari, C., Bueno, M., Doitchinova-Simeonova, M., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., and Lal, S.

Abstract

Contains fulltext : 220087.pdf (Publisher’s version ) (Closed access), BACKGROUND & AIMS: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF). METHODS: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions. RESULTS: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p < 0.001). IVS-admixture comprised: FE 10%, PA 17%, PAFE 17%, CA 38%, CAFE 18%. PA and PAFE prevailed in malignant-CIF while CA and CAFE use was greater in benign-CIF (p < 0.001). PA + PAFE prevailed in those countries where LP was the main HPN-provider and CA + CAFE prevailed where the main HPN-provider was HCC (p < 0.001). CONCLUSIONS: This is the first study to demonstrate that HPN provision and the IVS-admixture differ greatly among countries, among HPN centers and between benign-CIF and cancer-CIF. As both HPN provider and IVS-admixture types may play a role in the safety and effectiveness of HPN therapy, criteria to homogenize HPN programs are needed so that patients can have equal access to optimal CIF care.

Published
2020

10. Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure

Author

Pironi, L, Steiger, E., Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M.J., Cooper, S.C., Poullenot, F., Rasmussen, H.H., Compher, C.W., Crivelli, A., Hughes, S.J., Santarpia, L., Guglielmi, F.W., Kozjek, N. Rotovnik, Ellegard, L., Schneider, S.M., Matras, P., Forbes, A., Wyer, N., Zmarzly, A., Taus, M., O'Callaghan, M., Osland, E., Thibault, R., Cuerda, C., Jones, L., Chapman, B., Sahin, P., Virgili, N.M., Lee, A.D. Won, Orlandoni, P., Matysiak, K., Caro, S. Di, Doitchinova-Simeonova, M., Masconale, L., Spaggiari, C., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Jáuregui, E. Petrina, Murillo, A., Suárez-Llanos, J.P., Nardi, E., Gossum, A. van, Lal, S., Pironi, L, Steiger, E., Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M.J., Cooper, S.C., Poullenot, F., Rasmussen, H.H., Compher, C.W., Crivelli, A., Hughes, S.J., Santarpia, L., Guglielmi, F.W., Kozjek, N. Rotovnik, Ellegard, L., Schneider, S.M., Matras, P., Forbes, A., Wyer, N., Zmarzly, A., Taus, M., O'Callaghan, M., Osland, E., Thibault, R., Cuerda, C., Jones, L., Chapman, B., Sahin, P., Virgili, N.M., Lee, A.D. Won, Orlandoni, P., Matysiak, K., Caro, S. Di, Doitchinova-Simeonova, M., Masconale, L., Spaggiari, C., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Jáuregui, E. Petrina, Murillo, A., Suárez-Llanos, J.P., Nardi, E., Gossum, A. van, and Lal, S.

Abstract

Contains fulltext : 225267.pdf (Publisher’s version ) (Closed access), BACKGROUND AND AIM: No marker to categorise the severity of chronic intestinal failure (CIF) has been developed. A 1-year international survey was carried out to investigate whether the European Society for Clinical Nutrition and Metabolism clinical classification of CIF, based on the type and volume of the intravenous supplementation (IVS), could be an indicator of CIF severity. METHODS: At baseline, participating home parenteral nutrition (HPN) centres enrolled all adults with ongoing CIF due to non-malignant disease; demographic data, body mass index, CIF mechanism, underlying disease, HPN duration and IVS category were recorded for each patient. The type of IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorised as <1, 1-2, 2-3 and >3 L/day. The severity of CIF was determined by patient outcome (still on HPN, weaned from HPN, deceased) and the occurrence of major HPN/CIF-related complications: intestinal failure-associated liver disease (IFALD), catheter-related venous thrombosis and catheter-related bloodstream infection (CRBSI). RESULTS: Fifty-one HPN centres included 2194 patients. The analysis showed that both IVS type and volume were independently associated with the odds of weaning from HPN (significantly higher for PN <1 L/day than for FE and all PN >1 L/day), patients' death (lower for FE, p=0.079), presence of IFALD cholestasis/liver failure and occurrence of CRBSI (significantly higher for PN 2-3 and PN >3 L/day). CONCLUSIONS: The type and volume of IVS required by patients with CIF could be indicators to categorise the severity of CIF in both clinical practice and research protocols.

Published
2020

11. Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey

Author

Pironi, L, Steiger, E., Brandt, C, Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Zeraschi, S., Kelly, D., Szczepanek, K., Jukes, A., Caro, S. Di, Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Wu, J., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Pagano, M.C., Hughes, S.J., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Gillanders, L., Ellegard, L., Thibault, R., Matras, P., Zmarzly, A., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Sahin, P., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Izbéki, F., Spaggiari, C., Bueno, M., Doitchinova-Simeonova, M., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., Lal, S., Pironi, L, Steiger, E., Brandt, C, Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Zeraschi, S., Kelly, D., Szczepanek, K., Jukes, A., Caro, S. Di, Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Wu, J., Cooper, S.C., Rasmussen, H.H., Compher, C., Seguy, D., Crivelli, A., Pagano, M.C., Hughes, S.J., Guglielmi, F.W., Kozjek, N.R., Schneider, S.M., Gillanders, L., Ellegard, L., Thibault, R., Matras, P., Zmarzly, A., Matysiak, K., Gossum, A. van, Forbes, A., Wyer, N., Taus, M., Virgili, N.M., O'Callaghan, M., Chapman, B., Osland, E., Cuerda, C., Sahin, P., Jones, L., Lee, A.D. Won, Masconale, L., Orlandoni, P., Izbéki, F., Spaggiari, C., Bueno, M., Doitchinova-Simeonova, M., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Czako, L., Kekstas, G., Sanz-Paris, A., Jáuregui, E.P., Murillo, A.Z., Schafer, E., Arends, J., Suárez-Llanos, J.P., and Lal, S.

Abstract

Contains fulltext : 220087.pdf (Publisher’s version ) (Closed access), BACKGROUND & AIMS: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF). METHODS: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions. RESULTS: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p < 0.001). IVS-admixture comprised: FE 10%, PA 17%, PAFE 17%, CA 38%, CAFE 18%. PA and PAFE prevailed in malignant-CIF while CA and CAFE use was greater in benign-CIF (p < 0.001). PA + PAFE prevailed in those countries where LP was the main HPN-provider and CA + CAFE prevailed where the main HPN-provider was HCC (p < 0.001). CONCLUSIONS: This is the first study to demonstrate that HPN provision and the IVS-admixture differ greatly among countries, among HPN centers and between benign-CIF and cancer-CIF. As both HPN provider and IVS-admixture types may play a role in the safety and effectiveness of HPN therapy, criteria to homogenize HPN programs are needed so that patients can have equal access to optimal CIF care.

Published
2020

12. Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure

Author

Pironi, L, Steiger, E., Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M.J., Cooper, S.C., Poullenot, F., Rasmussen, H.H., Compher, C.W., Crivelli, A., Hughes, S.J., Santarpia, L., Guglielmi, F.W., Kozjek, N. Rotovnik, Ellegard, L., Schneider, S.M., Matras, P., Forbes, A., Wyer, N., Zmarzly, A., Taus, M., O'Callaghan, M., Osland, E., Thibault, R., Cuerda, C., Jones, L., Chapman, B., Sahin, P., Virgili, N.M., Lee, A.D. Won, Orlandoni, P., Matysiak, K., Caro, S. Di, Doitchinova-Simeonova, M., Masconale, L., Spaggiari, C., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Jáuregui, E. Petrina, Murillo, A., Suárez-Llanos, J.P., Nardi, E., Gossum, A. van, Lal, S., Pironi, L, Steiger, E., Joly, F., Wanten, G.J.A., Chambrier, C., Aimasso, U., Sasdelli, A.S., Szczepanek, K., Jukes, A., Theilla, M., Kunecki, M., Daniels, J., Serlie, M.J., Cooper, S.C., Poullenot, F., Rasmussen, H.H., Compher, C.W., Crivelli, A., Hughes, S.J., Santarpia, L., Guglielmi, F.W., Kozjek, N. Rotovnik, Ellegard, L., Schneider, S.M., Matras, P., Forbes, A., Wyer, N., Zmarzly, A., Taus, M., O'Callaghan, M., Osland, E., Thibault, R., Cuerda, C., Jones, L., Chapman, B., Sahin, P., Virgili, N.M., Lee, A.D. Won, Orlandoni, P., Matysiak, K., Caro, S. Di, Doitchinova-Simeonova, M., Masconale, L., Spaggiari, C., Garde, C., Serralde-Zúñiga, A.E., Olveira, G., Krznaric, Z., Jáuregui, E. Petrina, Murillo, A., Suárez-Llanos, J.P., Nardi, E., Gossum, A. van, and Lal, S.

Abstract

Contains fulltext : 225267.pdf (Publisher’s version ) (Closed access), BACKGROUND AND AIM: No marker to categorise the severity of chronic intestinal failure (CIF) has been developed. A 1-year international survey was carried out to investigate whether the European Society for Clinical Nutrition and Metabolism clinical classification of CIF, based on the type and volume of the intravenous supplementation (IVS), could be an indicator of CIF severity. METHODS: At baseline, participating home parenteral nutrition (HPN) centres enrolled all adults with ongoing CIF due to non-malignant disease; demographic data, body mass index, CIF mechanism, underlying disease, HPN duration and IVS category were recorded for each patient. The type of IVS was classified as fluid and electrolyte alone (FE) or parenteral nutrition admixture (PN). The mean daily IVS volume, calculated on a weekly basis, was categorised as <1, 1-2, 2-3 and >3 L/day. The severity of CIF was determined by patient outcome (still on HPN, weaned from HPN, deceased) and the occurrence of major HPN/CIF-related complications: intestinal failure-associated liver disease (IFALD), catheter-related venous thrombosis and catheter-related bloodstream infection (CRBSI). RESULTS: Fifty-one HPN centres included 2194 patients. The analysis showed that both IVS type and volume were independently associated with the odds of weaning from HPN (significantly higher for PN <1 L/day than for FE and all PN >1 L/day), patients' death (lower for FE, p=0.079), presence of IFALD cholestasis/liver failure and occurrence of CRBSI (significantly higher for PN 2-3 and PN >3 L/day). CONCLUSIONS: The type and volume of IVS required by patients with CIF could be indicators to categorise the severity of CIF in both clinical practice and research protocols.

Published
2020

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