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

Author

Nuria Virgili, Konrad Matysiak, Cristina Cuerda, Henrik Højgaard Rasmussen, Florian Poullenot, Ronan Thibault, Umberto Aimasso, Amelia Jukes, Andre Dong Won Lee, Brooke Chapman, Geert J. A. Wanten, Simona Di Caro, Maryana Doitchinova-Simeonova, Alastair Forbes, Corrado Spaggiari, Ezra Steiger, Elena Nardi, Cécile Chambrier, Simon Lal, Paolo Orlandoni, Peter Sahin, Marina Taus, Mireille J. Serlie, Kinga Szczepanek, A. Crivelli, Nicola Wyer, Przemysław Matras, Lynn Jones, Carmen Garde, Gabriel Olveira, Marek Kunecki, José P. Suárez-Llanos, Francisca Joly, Ana Zugasti Murillo, Joanne Daniels, Loris Pironi, Zeljko Krznaric, Emma Osland, Sheldon C. Cooper, Stéphane M. Schneider, Sarah Jane Hughes, Lars Ellegård, Miriam Theilla, Luisa Masconale, Anna Zmarzly, Aurora E. Serralde-Zúñiga, André Van Gossum, Anna Simona Sasdelli, Lidia Santarpia, Nada Rotovnik Kozjek, Francesco William Guglielmi, Margie O'Callaghan, Charlene Compher, Estrella Petrina Jáuregui, 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. Ho., Compher, C. W., Crivelli, A., Hughes, S. -J., Santarpia, L., Guglielmi, F. W., Rotovnik Kozjek, N., 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. W., Orlandoni, P., Matysiak, K., Di Caro, S., Doitchinova-Simeonova, M., Masconale, L., Spaggiari, C., Garde, C., Serralde-Zuniga, A. E., Olveira, G., Krznaric, Z., Petrina Jauregui, E., Zugasti Murillo, A., Suarez-Llanos, J. P., Nardi, E., Van Gossum, A., Lal, S., Pironi, Lori, Steiger, Ezra, Joly, Francisca, Wanten, Geert J A, Chambrier, Cecile, Aimasso, Umberto, Sasdelli, Anna Simona, Szczepanek, Kinga, Jukes, Amelia, Theilla, Miriam, Kunecki, Marek, Daniels, Joanne, Serlie, Mireille J, Cooper, Sheldon C, Poullenot, Florian, Rasmussen, Henrik Højgaard, Compher, Charlene W, Crivelli, Adriana, Hughes, Sarah-Jane, Santarpia, Lidia, Guglielmi, Francesco William, Rotovnik Kozjek, Nada, Ellegard, Lar, Schneider, Stéphane M, Matras, Przemysław, Forbes, Alastair, Wyer, Nicola, Zmarzly, Anna, Taus, Marina, O'Callaghan, Margie, Osland, Emma, Thibault, Ronan, Cuerda, Cristina, Jones, Lynn, Chapman, Brooke, Sahin, Peter, Virgili, Núria M, Lee, Andre Dong Won, Orlandoni, Paolo, Matysiak, Konrad, Di Caro, Simona, Doitchinova-Simeonova, Maryana, Masconale, Luisa, Spaggiari, Corrado, Garde, Carmen, Serralde-Zúñiga, Aurora E, Olveira, Gabriel, Krznaric, Zeljko, Petrina Jáuregui, Estrella, Zugasti Murillo, Ana, Suárez-Llanos, José P, Nardi, Elena, Van Gossum, André, Lal, Simon, University of Bologna, Cleveland Clinic, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Radboud university [Nijmegen], Hospices Civils de Lyon (HCL), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Aalborg University [Denmark] (AAU), Sahlgrenska Academy at University of Gothenburg [Göteborg], Centre Hospitalier Universitaire de Nice (CHU Nice), Medical University of Lublin, University of East Anglia [Norwich] (UEA), University Hospital Coventry, CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Hospital General Universitario 'Gregorio Marañón' [Madrid], Austin Health, Universidade de São Paulo (USP), Poznan University of Life Sciences (Uniwersytet Przyrodniczy w Poznaniu) (PULS), University College London Hospitals (UCLH), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán - National Institute of Medical Science and Nutrition Salvador Zubiran [Mexico], University of Manchester [Manchester], European Society for Clinical Nutrition and Metabolism (ESPEN)., Endocrinology, AGEM - Endocrinology, metabolism and nutrition, University of Bologna/Università di Bologna, Radboud University [Nijmegen], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Universidade de São Paulo = University of São Paulo (USP)

Subjects
Male, 0301 basic medicine, [SDV]Life Sciences [q-bio], Severity of Illness Index, Liver disease, 0302 clinical medicine, Drug Dosage Calculations, motility disorder, 2. Zero hunger, Gastroenterology, Short bowel syndrome, 3. Good health, Chronic intestinal failure, Intestines, Pharmaceutical Solutions, Venous thrombosis, Intestinal obstruction, motility disorders, Administration, Intravenous, Female, 030211 gastroenterology & hepatology, Parenteral Nutrition, Home, Adult, Fat Emulsions, Intravenous, medicine.medical_specialty, parenteral nutrition, macromolecular substances, Clinical nutrition, short bowel syndrome, 03 medical and health sciences, Cholestasis, intestinal failure, Internal medicine, medicine, Humans, 030109 nutrition & dietetics, business.industry, liver failure, medicine.disease, Intestinal Diseases, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Parenteral nutrition, Alimentació parenteral, Intestinal Absorption, Catheter-Related Infections, Parenteral feeding, Chronic Disease, Obstrucció intestinal, Fluid Therapy, business, Body mass index
Abstract

Background and aimNo 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.MethodsAt 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 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).ResultsFifty-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), 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).ConclusionsThe 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

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

Author

Loris Pironi, Ezra Steiger, Francisca Joly, Palle B. Jeppesen, Geert Wanten, Anna S. Sasdelli, Cecile Chambrier, Umberto Aimasso, Manpreet S. Mundi, Kinga Szczepanek, Amelia Jukes, Miriam Theilla, Marek Kunecki, Joanne Daniels, Mireille Serlie, Florian Poullenot, Sheldon C. Cooper, Henrik H. Rasmussen, Charlene Compher, David Seguy, Adriana Crivelli, Lidia Santarpia, Francesco W. Guglielmi, Nada Rotovnik Kozjek, Stéphane M. Schneider, Lars Ellegard, Ronan Thibault, Przemysław Matras, Konrad Matysiak, Andrè Van Gossum, Alastair Forbes, Nicola Wyer, Marina Taus, Nuria M. Virgili, Margie O'Callaghan, Brooke Chapman, Emma Osland, Cristina Cuerda, Gábor Udvarhelyi, Lynn Jones, Andre D. Won Lee, Luisa Masconale, Paolo Orlandoni, Corrado Spaggiari, Marta Bueno Díez, Maryana Doitchinova-Simeonova, Aurora E. Serralde-Zúñiga, Gabriel Olveira, Zeljko Krznaric, Laszlo Czako, Gintautas Kekstas, Alejandro Sanz-Paris, Mª Estrella Petrina Jáuregui, Ana Zugasti Murillo, Eszter Schafer, Jann Arends, José P. Suárez-Llanos, Nader N. Youssef, Giorgia Brillanti, Elena Nardi, Simon Lal, Adriana N. Crivelli, Hector Solar Muñiz, Brooke R. Chapman, Ruth Hodgson, Siobhan Wallin, Kay Lasenby, Andre Van Gossum, Andre Dong Won Lee, Henrik Højgaard Rasmussen, Chrisoffer Brandt, Vanessa Boehm, Julie Bataille, Lore Billiauws, Tomas Molnar, Mihaly Zsilak-Urban, Ferenc Izbéki, Peter Sahin, Anna Simona Sasdelli, Merlo F. Dario, Valentino Bertasi, Nunzia Regano, Santarpia Lidia, Lucia Alfonsi, Debora Busni, Lyn Gillanders, Anna Zmarzly, Marta Bueno, Carmen Garde, Ma Estrella Petrina Jáuregui, Cora Jonker, Simona Di Caro, Niamh Keane, Pinal Patel, Sarah-Jane Nelson Hughes, Rachel Lloyd, Arun Abraham, Gerda Garside, Michael Taylor, Jian Wu, Trevor Smith, Charlotte Pither, Michael Stroud, Reena Parmar, Nicola Burch, Sarah Zeraschi, Manpreet Mundi, Denise Jezerski, Pironi L., Steiger E., Joly F., Jeppesen P.B., Wanten G., Sasdelli A.S., Chambrier C., Aimasso U., Mundi M.M., 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., Van Gossum A., Forbes A., Wyer N., Taus M., Virgili N.M., O'Callaghan M., Chapman B., Osland E., Cuerda C., Udvarhelyi G., Jones L., Won Lee A.D., Masconale L., Orlandoni P., Spaggiari C., Diez M.B., Doitchinova-Simeonova M., Serralde-Zuniga A.E., Olveira G., Krznaric Z., Czako L., Kekstas G., Sanz-Paris A., Jauregui M.E.P., Murillo A.Z., Schafer E., Arends J., Suarez-Llanos J.P., Youssef N.N., Brillanti G., Nardi E., Lal S., Crivelli A.N., Muniz H.S., Chapman B.R., Hodgson R., Wallin S., Lasenby K., Brandt C., Boehm V., Bataille J., Billiauws L., Molnar T., Zsilak-Urban M., Izbeki F., Sahin P., Dario M.F., Bertasi V., Regano N., Lidia S., Alfonsi L., Busni D., Gillanders L., Zmarzly A., Bueno M., Garde C., Jonker C., Di Caro S., Keane N., Patel P., Nelson Hughes S.-J., Lloyd R., Abraham A., Garside G., Taylor M., Wu J., Smith T., Pither C., Stroud M., Parmar R., Burch N., Zeraschi S., Mundi M., Jezerski D., Endocrinology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, University of Bologna, Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Cleveland Clinic, Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Rigshospitalet [Copenhagen], Copenhagen University Hospital, Radboud University Medical Center [Nijmegen], Hospices Civils de Lyon (HCL), Città della Salute e della Scienza University-Hospital, Mayo Clinic and Mayo College of Medicine, Rochester, Stanley Dudrick's Memorial Hospital, Partenaires INRAE, University Hospital of Wales, Tel Aviv University [Tel Aviv], University of Lódź, Nottingham University Hospitals NHS Trust [UK], VU University Medical Center [Amsterdam], CHU Bordeaux [Bordeaux], University Hospitals Birmingham NHS Foundation Trust, Aalborg University Hospital, Hospital of the University of Pennsylvania (HUP), Perelman School of Medicine, University of Pennsylvania [Philadelphia]-University of Pennsylvania [Philadelphia], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hospital Universitario Fundacion Favaloro, University of Naples Federico II, Monsignor di Miccoli Hospital, Institute of Oncology - Ljubljana, Institute of Oncology Ljubljana, Centre Hospitalier Universitaire de Nice (CHU Nice), University of Gothenburg (GU), The project of the ESPEN database for Chronic Intestinal Failure was promoted by the ESPEN Executive Committee in 2013, was approved by the ESPEN Council and was supported by an ESPEN grant., University of Bologna/Università di Bologna, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University Hospital of Wales (UHW), Tel Aviv University (TAU), Nottingham University Hospitals NHS Trust (NUH), University of Pennsylvania-University of Pennsylvania, University of Naples Federico II = Università degli studi di Napoli Federico II, and Institute of Oncology [Ljubljana]

Subjects
Parenteral Nutrition, Epidemiology, [SDV]Life Sciences [q-bio], Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, MESH: Intestinal Diseases, Malalties intestinals, 0302 clinical medicine, Indicadors de salut, Medicine, 030212 general & internal medicine, Intestines--Diseases, Nutrition and Dietetics, Intestinal Disease, Short bowel syndrome, Intestinal failure, Health status indicators, 3. Good health, Chronic intestinal failure, Intestine, Intestines, medicine.anatomical_structure, Cohort, 030211 gastroenterology & hepatology, Female, MESH: Intestines, Human, Adult, Short Bowel Syndrome, medicine.medical_specialty, Anastomosis, 03 medical and health sciences, Ileocecal valve, MESH: Cross-Sectional Studies, epidemiology, home parenteral nutrition, intestinal failure, intravenous supplementation, short bowel syndrome, Internal medicine, MESH: Short Bowel Syndrome, Humans, Cross-Sectional Studie, Home parenteral nutrition, MESH: Humans, business.industry, MESH: Adult, medicine.disease, Intravenous supplementation, Intestinal Diseases, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Parenteral nutrition, Cross-Sectional Studies, Jejunostomy, business, MESH: Female, MESH: Parenteral Nutrition
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 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

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

Author

Pironi, Loris, Steiger, Ezra, Brandt, Chrisoffer, Joly, Francisca, Wanten, Geert, Chambrier, Cecile, Aimasso, Umberto, Sasdelli, Anna Simona, Zeraschi, Sarah, Kelly, Darlene, Szczepanek, Kinga, Jukes, Amelia, Di Caro, Simona, Theilla, Miriam, Kunecki, Marek, Daniels, Joanne, Serlie, Mireille, Poullenot, Florian, Wu, Jian, Cooper, Sheldon C, Rasmussen, Henrik H, Compher, Charlene, Seguy, David, Crivelli, Adriana, Pagano, Maria C, Hughes, Sarah-Jane, Guglielmi, Francesco W, Kozjek, Nada Rotovnik, Schneider, Stéphane M, Gillanders, Lyn, Ellegard, Lars, Thibault, Ronan, Matras, Przemysław, Zmarzly, Anna, Matysiak, Konrad, Van Gossum, Andrè, Forbes, Alastair, Wyer, Nicola, Taus, Marina, Virgili, Nuria M, O'Callaghan, Margie, Chapman, Brooke, Osland, Emma, Cuerda, Cristina, Sahin, Peter, Jones, Lynn, Won Lee, Andre Dong, Masconale, Luisa, Orlandoni, Paolo, Izbéki, Ferenc, Spaggiari, Corrado, Bueno, Marta, Doitchinova-Simeonova, Maryana, Garde, Carmen, Serralde-Zúñiga, Aurora E, Olveira, Gabriel, Krznaric, Zeljko, Czako, Laszlo, Kekstas, Gintautas, Sanz-Paris, Alejandro, Jáuregui, Estrella Petrina, Murillo, Ana Zugasti, Schafer, Eszter, Arends, Jann, Suárez-Llanos, José P, Lal, Simon, Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN, European Society for Clinical Nutrition and Metabolism, Pironi L., Steiger E., Brandt C., Joly F., Wanten G., Chambrier C., Aimasso U., Sasdelli A.S., Zeraschi S., Kelly D., Szczepanek K., Jukes A., Di Caro S., 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., Van Gossum A., Forbes A., Wyer N., Taus M., Virgili N.M., O'Callaghan M., Chapman B., Osland E., Cuerda C., Sahin P., Jones L., Won Lee A.D., Masconale L., Orlandoni P., Izbeki F., Spaggiari C., Bueno M., Doitchinova-Simeonova M., Garde C., Serralde-Zuniga A.E., Olveira G., Krznaric Z., Czako L., Kekstas G., Sanz-Paris A., Jauregui E.P., Murillo A.Z., Schafer E., Arends J., Suarez-Llanos J.P., Lal S., St. Orsola University Hospital, Cleveland Clinic, Rigshospitalet [Copenhagen], Copenhagen University Hospital, Radboud University Medical Center [Nijmegen], Hospices Civils de Lyon, Departement de Neurologie (HCL), Leeds Teaching Hospitals NHS Trust, University Hospital of Wales, Rabin Medical Center, Nottingham University Hospital NHS Trust, Department of Infectious Diseases [Amsterdam, Netherlands] (Academic Medical Center), University of Amsterdam [Amsterdam] (UvA)-Center for Tropical and Travel Medicine [Amsterdam, Netherlands], University Hospital Southampton NHS Foundation Trust, University Hospitals Birmingham NHS Foundation Trust, 'Federico II' University of Naples Medical School, Sahlgrenska University Hospital [Gothenburg], Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), CHU Pontchaillou [Rennes], University Hospitals Birmingham NHS Foundation Trust Institut National de la Santé et de la Recherche Médicale University of Pennsylvania, PennRoyal Marsden NHS Foundation TrustNottingham University Hospitals NHS TrustCleveland Clinic FoundationUniversity Hospital Southampton NHS Foundation TrustChung Hua University Fondazione Città della SperanzaInstitut National de la Recherche Agronomique Hospices Civils de Lyon European Society for Clinical Nutrition and Metabolism, Endocrinology, AGEM - Endocrinology, metabolism and nutrition, University Hospital of Wales (UHW), Nottingham University Hospitals NHS Trust (NUH), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
0301 basic medicine, Male, medicine.medical_specialty, Internationality, [SDV]Life Sciences [q-bio], 030209 endocrinology & metabolism, Pharmacy, [SDV.CAN]Life Sciences [q-bio]/Cancer, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Health care, Chronic renal failure, Medicine, Humans, Medical prescription, Cancer, Home parenteral nutrition, 030109 nutrition & dietetics, Nutrition and Dietetics, Modalities, Adult patients, Intestinal failure, Intravenous supplementation, business.industry, International survey, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Middle Aged, Health Surveys, 3. Good health, Chronic intestinal failure, Intestinal Diseases, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Parenteral nutrition, Cross-Sectional Studies, Treatment Outcome, Alimentació parenteral, Chronic Disease, Parenteral feeding, Insuficiència renal crònica, Female, business, Parenteral Nutrition, Home, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
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

Published
2020

4. Home Enteral Nutrition in Adults—Nationwide Multicenter Survey

Author

Bogna Kwella, Marcin Folwarski, Agata Zoubek-Wojcik, Lidia Bartoszewska, Stanislaw Klek, Anna Jurczuk, Joanna Sonsala-Wołczyk, Zbigniew Kamocki, Jacek Szopiński, Waldemar Szafrański, Marlena Jakubczyk, Przemysław Matras, Krzysztof Figula, Tomasz Kowalczyk, Anna Zmarzly, Krystyna Urbanowicz, Karolina Skonieczna-Żydecka, and Karolina Kaźmierczak-Siedlecka

Subjects
0301 basic medicine, Male, Pediatrics, Time Factors, medicine.medical_treatment, Primary disease, Enteral administration, Cohort Studies, 0302 clinical medicine, Multicenter Studies as Topic, Nutritional Physiological Phenomena, Intubation, Gastrointestinal, Aged, 80 and over, Gastrostomy, education.field_of_study, Nutrition and Dietetics, Middle Aged, Nutrition Surveys, artificial nutrition, Home Care Services, Head and Neck Neoplasms, home enteral nutrition, Female, lcsh:Nutrition. Foods and food supply, Adult, medicine.medical_specialty, Population, lcsh:TX341-641, 030209 endocrinology & metabolism, Common method, Article, 03 medical and health sciences, Enteral Nutrition, medicine, Humans, education, tube feeding, Aged, Food, Formulated, 030109 nutrition & dietetics, business.industry, Cancer, medicine.disease, Parenteral nutrition, Jejunostomy, Multicenter survey, Poland, Nervous System Diseases, business, Energy Intake, home care, Food Science
Abstract

Home enteral nutrition (HEN) is an important part of the health care system, with a growing population of patients around the world. The aim of our study was to analyze one of the largest cohorts of HEN patients to provide the most recent data available in European literature. A multicenter, nation-wide survey in the period of 1 January 2018&ndash, 1 January 2019 was performed in Poland. Data concerning adult patients on HEN in 2018 during 1 year of observation time were analyzed: demographic characteristics, primary disease, technique of enteral feeding, diet formulation and amount of energy provided. A total of 4586 HEN patients (F: 46.7%, M: 53.3%) were included in the study. The primary diseases were: 54.5% neurological (17.4%&mdash, neurovascular, 13.7%&mdash, neurodegenerative), 33.9% cancer (20.2%&mdash, head and neck, 11.7%&mdash, gastrointestinal cancer), 2.5%-gastroenterology, 1.5%&mdash, inherited diseases. Of new registrations in 2018&mdash, cancer patients 46.3%, neurological patients 45.1%. The median age overall was: 64 yr., BMI-20.2 kg/m2, NRS 2002 score&mdash, 4.28. A total of 65% of patients were treated with PEG, 11.6% with surgical gastrostomy, 14.3% with naso-gastric tube and 7% with jejunostomy. Boluses were the most common method of feeding (74.4%). Gravity flow was used in 17.6% and peristaltic pump was used in 8% patients. The median energy provision was 1278 kcal/day and 24 kcal/kg/day. The most commonly used diets were: isocaloric (28.1%), protein-enriched isocaloric (20%) and protein-enriched hypercaloric (12%). The median overall duration of HEN was 354 days, 615 days for neurological and 209 days for cancer patients. A number of new registrations of cancer patients was significant and long duration of HEN in this group is encouraging. A developing spectrum of enteral formulas available enables more specified nutritional interventions.

Published
2020
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5. Home medical nutrition during SARS-CoV-2 pandemic – A position paper

Author

Kinga Szczepanek, Marcin Folwarski, Zbigniew Kamocki, Przemysław Matras, Michal Lawiński, Katarzyna Klepczyk, Stanislaw Klek, Wlodzimierz Cebulski, Marlena Jakubczyk, Lidia Bartoszewska, Maciej Sadowski, M. Sumlet, Jacek Sobocki, Krystyna Urbanowicz, Waldemar Szafrański, Agata Zoubek-Wojcik, Marek Kunecki, Anna Zmarzly, Maciej Matczuk, K. Majewska, and Katarzyna Matysiak-Lusnia

Subjects
0301 basic medicine, Parenteral Nutrition, medicine.medical_specialty, Consensus, Infectious Disease Transmission, Patient-to-Professional, Endocrinology, Diabetes and Metabolism, Pneumonia, Viral, Population, 030209 endocrinology & metabolism, Article, Patient Isolation, Betacoronavirus, 03 medical and health sciences, COVID-19 Testing, Enteral Nutrition, 0302 clinical medicine, Risk Factors, Patient-Centered Care, Pandemic, Humans, Infection control, Medicine, education, Pandemics, Personal Protective Equipment, Home enteral nutrition, Patient Care Team, education.field_of_study, Home parenteral nutrition, 030109 nutrition & dietetics, Nutrition and Dietetics, Clinical Laboratory Techniques, business.industry, SARS-CoV-2, Risk of infection, Equity (finance), COVID-19, HAN, HEN, Home Care Services, Harm, Systematic review, Caregivers, Family medicine, Position paper, Home medical nutritition, Coronavirus Infections, business, Delivery of Health Care
Abstract

Summary Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a worldwide rapidly spreading illness, Coronavirus Disease 2019 (COVID-19). Patients fed enterally and parenterally at home are exposed to the same risk of infection as the general population, but more prone to complications than others. Therefore the guidance for care-givers and care-takers of these patients is needed. Methods The literature search identified no relevant systematic reviews or studies on the subject. Therefore a panel of 21 experts from 13 home medical nutrition (HMN) centres in Poland was formed. Twenty-three key issues relevant to the management of SARS-CoV-2 infection or COVID-19 in the HMN settings were identified and discussed. Some statements diverge from the available nutrition, surgical or ICU guidelines, some are based on the best available experience. Each topic was discussed and assessed during two Delphi rounds subsequently. Statements were graded strong or weak based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Results the panel issued 23 statements, all of them were graded strong. Two scored 85.71% agreement, eleven 95.23%, and ten 100%. The topics were: infection control, enrolment to HMN, logistics and patient information. Conclusions the position paper present pragmatic statements for HMN to be implemented in places without existing protocols for SARS-CoV-2 pandemic. They represent the state of knowledge available at the moment and may change should new evidence occurs.

Published
2020

6. Clinical classification of adult patients with chronic intestinal failure due to benign disease: An international multicenter cross-sectional survey

Author

Anna Zmarzly, Paolo Orlandoni, Laszlo Czako, Jian Wu, André Van Gossum, Gintautas Kekstas, Marina Taus, Ferenc Izbéki, Geert J. A. Wanten, Lynn Jones, Chrisoffer Brandt, Simona Di Caro, Alastair Forbes, Stéphane M. Schneider, A. Crivelli, Jon Shaffer, Francisca Joly, Ana Zugasti Murillo, Eszter Schafer, Gabriel Olveira, Sheldon C. Cooper, Lyn Gillanders, Henrik Erreboe Schou Rasmussen, Sarah Zeraschi, Peter Sahin, Jann Arends, Marta Bueno Díez, Brooke Chapman, Corrado Spaggiari, Cristina Cuerda, Sarah Jane Hughes, Miriam Theilla, Przemysław Matras, Denise Konrad, Nada Rotovnik Kozjek, Francesco William Guglielmi, Margie O'Callaghan, Charlene Compher, Maria Carmen Pagano, Alejandro Sanz-Paris, Cécile Chambrier, Andre Dong Won Lee, Emma Osland, Simon Lal, Valentino Bertasi, Joanne Daniels, Ronan Thibault, Carmen Garde, Lars Ellegård, Federica Agostini, Zeljko Krznaric, Aurora E. Serralde-Zúñiga, Konrad Matysiak, Umberto Aimasso, Loris Pironi, Florian Poullenot, Amelia Jukes, Marek Kunecki, Maryana Doitchinova-Simeonova, José P. Suárez-Llanos, Kinga Szczepanek, David Seguy, Mireille J. Serlie, Nicola Wyer, Estrella Petrina Jáuregui, Nuria Virgili, Darlene G. Kelly, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Endocrinology, Pironi, Lori, Konrad, Denise, Brandt, Chrisoffer, Joly, Francisca, Wanten, Geert, Agostini, Federica, Chambrier, Cecile, Aimasso, Umberto, Zeraschi, Sarah, Kelly, Darlene, Szczepanek, Kinga, Jukes, Amelia, Di Caro, Simona, Theilla, Miriam, Kunecki, Marek, Daniels, Joanne, Serlie, Mireille, Poullenot, Florian, Wu, Jian, Cooper, Sheldon C., Rasmussen, Henrik H., Compher, Charlene, Seguy, David, Crivelli, Adriana, Pagano, Maria C., Hughes, Sarah-Jane, Guglielmi, Francesco W., Kozjek, Nada Rotovnik, Schneider, Stéphane M., Gillanders, Lyn, Ellegard, Lar, Thibault, Ronan, Matras, Przemyså aw, Zmarzly, Anna, Matysiak, Konrad, Van Gossum, Andrã, Forbes, Alastair, Wyer, Nicola, Taus, Marina, Virgili, Nuria M., O'Callaghan, Margie, Chapman, Brooke, Osland, Emma, Cuerda, Cristina, Sahin, Peter, Jones, Lynn, Lee, Andre D.W., Bertasi, Valentino, Orlandoni, Paolo, Izbã©ki, Ferenc, Spaggiari, Corrado, Dã­ez, Marta Bueno, Doitchinova-Simeonova, Maryana, Garde, Carmen, Serralde-Zúñiga, Aurora E., Olveira, Gabriel, Krznaric, Zeljko, Czako, Laszlo, Kekstas, Gintauta, Sanz-Paris, Alejandro, Jã¡uregui, Estrella Petrina, Murillo, Ana Zugasti, Schafer, Eszter, Arends, Jann, Suárez-Llanos, José P., Shaffer, Jon, and Lal, Simon

Subjects
Male, 0301 basic medicine, Cross-sectional study, Critical Care and Intensive Care Medicine, Chronic intestinal pseudo-obstruction, 0302 clinical medicine, chronic intestinal pseudo-obstruction, home parenteral nutrition, intestinal failure, intravenous supplementation, short bowel syndrome, Intestinal failure, Nutrition and Dietetic, Israel, Aged, 80 and over, Nutrition and Dietetics, Benign disease, Short bowel syndrome, Middle Aged, Chronic intestinal failure, Europe, Intestines, Female, 030211 gastroenterology & hepatology, Parenteral Nutrition, Home, Adult, medicine.medical_specialty, Adolescent, Energy requirement, Young Adult, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Internal medicine, medicine, Humans, Intensive care medicine, Aged, Home parenteral nutrition, 030109 nutrition & dietetics, Australasia, Adult patients, business.industry, South America, medicine.disease, Intravenous supplementation, United States, Intestinal Diseases, Cross-Sectional Studies, Parenteral nutrition, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Chronic Disease, business
Abstract

BACKGROUND & AIMS: The aim of the study was to evaluate the applicability of the ESPEN 16-category clinical classification of chronic intestinal failure, based on patients' intravenous supplementation (IVS) requirements for energy and fluids, and to evaluate factors associated with those requirements.METHODS: ESPEN members were invited to participate through ESPEN Council representatives. Participating centers enrolled adult patients requiring home parenteral nutrition for chronic intestinal failure on March 1st 2015. The following patient data were recorded though a structured database: sex, age, body weight and height, intestinal failure mechanism, underlying disease, IVS volume and energy need.RESULTS: Sixty-five centers from 22 countries enrolled 2919 patients with benign disease. One half of the patients were distributed in 3 categories of the ESPEN clinical classification. 9% of patients required only fluid and electrolyte supplementation. IVS requirement varied considerably according to the pathophysiological mechanism of intestinal failure. Notably, IVS volume requirement represented loss of intestinal function better than IVS energy requirement. A simplified 8 category classification of chronic intestinal failure was devised, based on two types of IVS (either fluid and electrolyte alone or parenteral nutrition admixture containing energy) and four categories of volume.CONCLUSIONS: Patients' IVS requirements varied widely, supporting the need for a tool to homogenize patient categorization. This study has devised a novel, simplified eight category IVS classification for chronic intestinal failure that will prove useful in both the clinical and research setting when applied together with the underlying pathophysiological mechanism of the patient's intestinal failure.

Published
2018

7. Home enteral nutrition in children—2010 nationwide survey of the polish society for clinical nutrition of children

Author

Beata Gębora-Kowalska, Anna Borkowska, Marlena Jakubczyk, Marek Wilczyński, Ilona Zagozdzon, Przemysław Matras, Ewa Hapyn, Stanislaw Klek, Katarzyna Popińska, Jarosław Kierkuś, Janusz Książyk, Anna Zmarzly, Adam Daukszewicz, Urszula Grzybowska-Chlebowczyk, Ewa Toporowska-Kowalska, Agnieszka Szlagatys-Sidorkiewicz, Mariola Lembas-Sznabel, M. Sibilska, and Sabina Więcek

Subjects
Male, Pediatrics, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Jejunostomy, Home Care Services, Hospital-Based, Clinical nutrition, Spinal Muscular Atrophies of Childhood, Enteral administration, Enteral Nutrition, Intellectual Disability, medicine, Humans, Pediatrics, Perinatology, and Child Health, Child, Children, Home enteral nutrition, Retrospective Studies, Gastrostomy, Lennox Gastaut Syndrome, business.industry, Cerebral Palsy, Public health, Infant, Retrospective cohort study, Parenteral nutrition, El Niño, Child, Preschool, Health Care Surveys, Pediatrics, Perinatology and Child Health, Female, Original Article, Poland, business, Spasms, Infantile
Abstract

Published epidemiologic data on the administration rates of enteral/parenteral home nutrition is very limited. The aim of this first nationwide study was to assess the availability of pediatric home enteral nutrition (HEN) services in Poland. The questionnaire was sent to all regional centers providing pediatric HEN services in Poland (n = 14). The analysis included the number of pediatric patients who received HEN in 2010, their demographic characteristics and geographical distribution. Furthermore, the distributions of indications and methods of enteral nutrition administration were analyzed, along with the reasons of withdrawal from the HEN program. The number and fraction of children receiving HEN increased in 2010, from 433 (11.34 per 1 million inhabitants) on January 1st to 525 (13.75) on December 31st. Marked differences were observed in geographical distribution of this parameter, from zero to up to 30 pediatric patients per 1 million inhabitants. Median age of patients was 6 years (range: 9 months–18 years). In most cases, HEN was prescribed due to neurological disorders (n = 337, 64.2%), and administered by means of gastrostomy (n = 450, 85.71%). This study revealed the dynamic development of pediatric HEN services in Poland but also documented their potential regional shortages.

Published
2011

10. PP074-MON SHOULD GLUTAMINE BE ADMINISTERED TO SURGICAL PATIENTS?

Author

M. Szpetnar, M. Matuszek, K. Żuchowska, Anna Zmarzly, S.R. Rudzki, and Przemysław Matras

Subjects
Glutamine, medicine.medical_specialty, Nutrition and Dietetics, business.industry, medicine, Critical Care and Intensive Care Medicine, business, Surgery, Surgical patients
Published
2013

11. PP212-SUN HOME ENTERAL NUTRITION IN CHILDREN – POLISH MULTICENTER SURVEY

Author

P. Matras, A. Daukszewicz, M. Sibilska, M. Wilczynski, Agnieszka Szlagatys-Sidorkiewicz, U. Chlebowczyk, A. Zmarzly, M. Lembas-Sznabel, Janusz Ksiazyk, Beata Gębora-Kowalska, Katarzyna Popińska, E. Toporowska-Kowalska, I. Zagozdzon, Sabina Więcek, Ewa Hapyn, Jaroslaw Kierkus, M. Jakubczyk, and Anna Borkowska

Subjects
medicine.medical_specialty, Nutrition and Dietetics, Parenteral nutrition, business.industry, Family medicine, Multicenter survey, Medicine (miscellaneous), Medicine, Critical Care and Intensive Care Medicine, business
Published
2011

12. Clinical nutrition in adult palliative care cancer patients - recommendations of the Polish Society for Clinical Nutrition, the Polish Society of Paliative Medicine, the Polish Society of Family Medicine, Polish Society of Palliative Care Nursing in association with the Polish Society of Clinical Oncology and the Polish Society of Gastroenterology

Author

Jacek Sobocki, Aleksandra Ciałkowska-Rysz, Przemysław Matras, Krystyna Urbanowicz, Iwona Traczyk, Iwona Filipczak-Bryniarska, Tomasz Dzierżanowski, Jarosław Drobnik, Konrad Matysiak, K. Majewska, Grażyna Rydzewska, Maciej Krzakowski, Marek Kunecki, Agnieszka Mastalerz-Migas, Izabela Kaptacz, Natalia Konik, Anna Zmarzly, and Sławomir Rudzki

Subjects
Clinical Oncology, medicine.medical_specialty, business.industry, Family medicine, medicine, Palliative Care Nursing, Palliative care cancer, Clinical nutrition, business

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