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

Loris Pironi 1, * Ezra Steiger 2 Francisca Joly 3 Geert Wanten 4 Cécile Chambrier 5 Umberto Aimasso Anna Simona Sasdelli 1 Kinga Szczepanek Amelia Jukes Miriam Theilla Marek Kunecki Joanne Daniels Mireille Serlie Sheldon Cooper Florian Poullenot 6 Henrik Hojgaard Rasmussen 7 Charlene Compher Adriana Crivelli Sarah-Jane Hughes Lidia Santarpia Francesco William Guglielmi Nada Rotovnik Kozjek Lars Ellegård 8 Stéphane Schneider 9 Przemysław Matras 10 Alastair Forbes 11 Nicola Wyer 12 Anna Zmarzly Marina Taus Margie O'Callaghan Emma Osland Ronan Thibault 13, 14 Cristina Cuerda 15 Lynn Jones Brooke Chapman 16 Peter Sahin Núria Virgili Andre Dong Won Lee 17 Paolo Orlandoni Konrad Matysiak 18 Simona Di Caro 19 Maryana Doitchinova-Simeonova Luisa Masconale Corrado Spaggiari Carmen Garde Aurora Serralde-Zúñiga 20 Gabriel Olveira Zeljko Krznaric Estrella Petrina Jáuregui Ana Zugasti Murillo José Suárez-Llanos Elena Nardi 1 André van Gossum Simon Lal 21
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 <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).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 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).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.
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-02533447
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Submitted on : Wednesday, November 18, 2020 - 2:01:30 PM
Last modification on : Monday, November 30, 2020 - 1:41:03 PM

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Loris Pironi, Ezra Steiger, Francisca Joly, Geert Wanten, Cécile Chambrier, et al.. Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure. Gut, BMJ Publishing Group, 2020, 69 (10), pp.1787-1795. ⟨10.1136/gutjnl-2018-318172⟩. ⟨hal-02533447⟩

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