Mistakes in intestinal failure and parenteral nutrition

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Mistakes in intestinal failure and parenteral nutrition

Samreen Malik, Sarah Williams, Shameer Mehta

Summary

AI Generated

Parenteral nutrition is intravenous nutrient delivery used to treat intestinal failure when gut absorption is insufficient to maintain health.

The European Society for Clinical Nutrition and Metabolism classifies intestinal failure into acute type 1 and chronic types 2 and 3, with chronic cases often requiring long-term home parenteral nutrition.
Intestinal failure is rare but its prevalence in Europe is rising.
Parenteral nutrition formulations are complex and require skilled management by a specialized multi-disciplinary team to avoid complications.
This material is relevant for clinicians managing patients with intestinal failure or those involved in parenteral nutrition support teams.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10 Mistake 11

Pironi L, Arends J, Bozzetti F, et al. ESPEN guidelines on chronic intestinal failure in adults. Clin Nutr 2016; 35: 247–307. [Link]

Naghibi M, Toskas A, Willsmore J, et al. United Kingdom artificial nutrition database: The changing landscape of adult home parenteral support. J Parenter Enter Nutr 2023; 47: 635–645. [Link]

Fuhrman MP. The Albumin-nutrition connection: separating myth from fact. Nutrition 2002; 18: 199–200. [Link]

Fuhrman MP, Charney P, Mueller CM. Hepatic proteins and nutrition assessment. J Am Diet Assoc 2004; 104: 1258–1264. [Link]

Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: Pathogenesis and Clinical Significance. J Parenter Enter Nutr 2019; 43: 181–193. [Link]

Levitt D, Levitt M. Human serum albumin homeostasis: a new look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements. Int J Gen Med 2016; Volume 9: 229–255. [Link]

Eckart A, Struja T, Kutz A, et al. Relationship of Nutritional Status, Inflammation, and Serum Albumin Levels During Acute Illness: A Prospective Study. Am J Med 2020; 133: 713-722.e7. [Link]

Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 2019; 38: 48–79. [Link]

Cederholm T, Barazzoni R, Austin P, et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr 2017; 36: 49–64. [Link]

10.

Chakraborty RK, Burns B. Systemic Inflammatory Response Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing, http://www.ncbi.nlm.nih.gov/books/NBK547669/ (2024, accessed 6 August 2024). [Link]

11.

Duncan A, Talwar D, McMillan DC, et al. Quantitative data on the magnitude of the systemic inflammatory response and its effect on micronutrient status based on plasma measurements. Am J Clin Nutr 2012; 95: 64–71. [Link]

12.

Galloway SP, McMillan DC, Sattar N. Effect of the inflammatory response on trace element and vitamin status. Ann Clin Biochem Int J Lab Med 2000; 37: 289–297. [Link]

13.

Berger MM, Shenkin A, Schweinlin A, et al. ESPEN micronutrient guideline. Clin Nutr 2022; 41: 1357–1424. [Link]

14.

SMOF Kabiven emulsion for infusion- Summary of Product Characteristics (SmPC), https://www.fresenius-kabi.com/my/documents/SmPC_SmofKabiven-SmofKabivenP.pdf (accessed 7 August 2024). [Link]

15.

Lipoflex special emulsion for infusion - Summary of Product Characteristics (SmPC) - (emc), https://www.medicines.org.uk/emc/product/15178/smpc#gref (accessed 7 August 2024). [Link]

16.

Bublin M, Breiteneder H. Cross-Reactivity of Peanut Allergens. Curr Allergy Asthma Rep 2014; 14: 426. [Link]

17.

Padhi S, Bullock I, Li L, et al. Intravenous fluid therapy for adults in hospital: summary of NICE guidance. BMJ 2013; 347: f7073–f7073. [Link]

18.

National Institute for Health and Care Excellence (NICE). CG174 Intravenous Fluid Therapy in Adults in Hospital: guideline. NICE clinical guidelines., https://www.nice.org.uk/guidance/cg174/ (2013, accessed 6 August 2024). [Link]

19.

Lyerly HK. The Handbook of Surgical Intensive Care: Practices of the Surgery Residents at the Duke University Medical Center. Year Book Medical Publishers, 1989. [Link]

20.

Lee HA. Parenteral Nutrition in Acute Metabolic Illness. Academic Press, 1974. [Link]

21.

Trissel LA, Gilbert DL, Martinez JF, et al. Compatibility of Medications With 3‐in‐1 Parenteral Nutrition Admixtures. J Parenter Enter Nutr 1999; 23: 67–74. [Link]

22.

Gilbar PJ, Groves CF. Visual Compatibility of Total Parenteral Nutrition Solution (Synthamin 17 Premix (R)) with Selected Drugs During Simulated Y-Site Injection. Aust J Hosp Pharm 1994; 24: 167–173 [Link]

23.

Clare A, Teubner A, Shaffer JL. What information should lead to a suspicion of catheter sepsis in HPN? Clin Nutr 2008; 27: 552–556. [Link]

24.

Mermel LA, Allon M, Bouza E, et al. Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis 2009; 49: 1–45. [Link]

25.

Beekmann SE, Diekema DJ, Huskins WC, et al. Diagnosing and Reporting of Central Line–Associated Bloodstream Infections. Infect Control Hosp Epidemiol 2012; 33: 875–882. [Link]

26.

Cloutier A, Lal S, Nightingale J. Top Tips for Managing Catheter-Related Blood Stream Infection in Patients Receiving Home Parenteral Support, https://www.bapen.org.uk/pdfs/bifa/bifa-top-tips-series-6.pdf (2019, accessed 7 August 2024). [Link]

27.

Fernandez-Hidalgo N. Antibiotic-lock therapy for long-term intravascular catheter-related bacteraemia: results of an open, non-comparative study. J Antimicrob Chemother 2006; 57: 1172–1180. [Link]

28.

Vincent J-L, Angus DC, Artigas A, et al. Effects of drotrecogin alfa (activated) on organ dysfunction in the PROWESS trial*: Crit Care Med 2003; 31: 834–840. [Link]

29.

Brun-Buisson C, Meshaka P, Pinton P, et al. EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive care units. Intensive Care Med 2004; 30: 580–588. [Link]

30.

Baker M, Nightingale J. Abnormal liver function tests and parenteral nutrition. Clin Nutr 2004; 23: 864–865. [Link]

31.

Cazals‐Hatem D, Billiauws L, Rautou P, et al. Ultra‐short bowel is an independent risk factor for liver fibrosis in adults with home parenteral nutrition. Liver Int 2018; 38: 174–182. [Link]

32.

Cavicchi M, Beau P, Crenn P, et al. Prevalence of Liver Disease and Contributing Factors in Patients Receiving Home Parenteral Nutrition for Permanent Intestinal Failure. Ann Intern Med 2000; 132: 525. [Link]

33.

Gabe SM, Culkin A. Abnormal liver function tests in the parenteral nutrition fed patient. Frontline Gastroenterol 2010; 1: 98–104. [Link]

34.

Quigley EMM, Marsh MN, Shaffer JL, et al. Hepatobiliary complications of total parenteral nutrition. Gastroenterology 1993; 104: 286–301. [Link]

35.

Vanek VW, Seidner DL, Allen P, et al. A.S.P.E.N. Position Paper: Clinical Role for Alternative Intravenous Fat Emulsions. Nutr Clin Pract 2012; 27: 150–192. [Link]

36.

Anez-Bustillos L, Dao DT, Fell GL, et al. Redefining essential fatty acids in the era of novel intravenous lipid emulsions. Clin Nutr 2018; 37: 784–789. [Link]

37.

Buchman AL, Ament ME, Sohel M, et al. Choline Deficiency Causes Reversible Hepatic Abnormalities in Patients Receiving Parenteral Nutrition: Proof of a Human Choline Requirement: A Placebo‐Controlled Trial. J Parenter Enter Nutr 2001; 25: 260–268. [Link]

38.

Farrer K, Harrison S, Baker M, et al. British Intestinal Failure Alliance (BIFA) Position Statement, https://www.bapen.org.uk/pdfs/bifa/position-statements/advice-during-a-shortage-of-iv-micronutrients-for-patients-receiving-pn-updated-08-11-21.pdf (2021, accessed 7 August 2024). [Link]

39.

Huisman-de Waal G, Bazelmans E, Van Achterberg T, et al. Predicting Fatigue in Patients Using Home Parenteral Nutrition: A Longitudinal Study. Int J Behav Med 2011; 18: 268–276. [Link]

40.

Huisman-de Waal G, Schoonhoven L, Jansen J, et al. The impact of home parenteral nutrition on daily life—A review. Clin Nutr 2007; 26: 275–288. [Link]

41.

Cogle SV, Martindale RG, Ramos M, et al. Multicenter Prospective Evaluation of Parenteral Nutrition Preparation Time and Resource Utilization: 3‐Chamber Bags Compared With Hospital Pharmacy–Compounded Bags. J Parenter Enter Nutr 2021; 45: 1552–1558. [Link]

42.

Dibb M, Teubner A, Theis V, et al. Review article: the management of long‐term parenteral nutrition. Aliment Pharmacol Ther 2013; 37: 587–603. [Link]

43.

Cozzaglio L, Balzola F, Cosentino F, et al. Outcome of Cancer Patients Receiving Home Parenteral Nutrition. J Parenter Enter Nutr 1997; 21: 339–342. [Link]

44.

Naghibi M, Skinner C, Burden ST, et al. A multi-national survey of experience and attitudes towards commencing home parenteral nutrition for patients with advanced cancer. Clin Nutr ESPEN 2022; 47: 246–251. [Link]

45.

Naghibi M, Woodward J, Neild P. The British Intestinal Failure Alliance (BIFA) Position Statement Palliative parenteral nutrition (HPN) for patients with malignancy, https://www.bapen.org.uk/pdfs/bifa/position-statements/position-statement-on-palliative-hpn-for-patients-with-malignancy-dec-2020.pdf (2020, accessed 7 August 2024). [Link]

Abstract

Parenteral nutrition (PN) is the intravenous delivery of nutrients, commonly used to treat intestinal failure (IF). IF occurs when gut function is insufficient to absorb macronutrients, water, or electrolytes, requiring IV supplementation to maintain health. The European Society for Clinical Nutrition and Metabolism (ESPEN) classifies IF into acute (type 1) and chronic (types 2 and 3), with chronic cases often needing long-term home parenteral nutrition (HPN). Although IF is rare, its prevalence in Europe is rising. PN formulations are complex, requiring skilled management by a specialized multi-disciplinary team to avoid complications.

Topics

Small Intestine & Nutrition

Citation

Williams S, Malik S and Mehta S. Mistakes in intestinal failure and parenteral nutrition and how to avoid them. UEG Education 2024; 24: 18-23.

Published

2024

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