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11. Contrast Enhanced Computed Tomography Based Cumulated Thoracic Muscular Cross-Sectional Area and the Correlation to Single Muscle Groups of the Thorax; Pectoralis, Latissimus Dorsi, and Spinae Erector Muscles in Patients Without Chronic Diseases, a Pilot Study

Author

Brath, M.S.G., primary, Sahakyan, M., additional, Veiss-Pedersen, P., additional, Mark, E.B., additional, Frøkjær, J.B., additional, Østergaard, L.R., additional, Rasmussen, H.H., additional, and Weinreich, U.M., additional

Published
2022
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12. 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

13. 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

14. 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

15. Acute intestinal failure: International multicenter point-of-prevalence study

Author

Blaser, A.R., Ploegmakers, Ilse, Benoit, Michael, Hoist, Mette, Rasmussen, H.H., Burgos, R., Wanten, G.J.A., Pironi, L, Blaser, A.R., Ploegmakers, Ilse, Benoit, Michael, Hoist, Mette, Rasmussen, H.H., Burgos, R., Wanten, G.J.A., and Pironi, L

Abstract

Contains fulltext : 217363.pdf (Publisher’s version ) (Closed access)

Published
2020

38. Management of acute intestinal failure: A position paper from the European Society for Clinical Nutrition and Metabolism (ESPEN) Special Interest Group

Author

Klek, S., Forbes, A., Gabe, S., Holst, M., Wanten, G.J.A., Irtun, O., Damink, S.O., Panisic-Sekeljic, M., Pelaez, R.B., Pironi, L, Blaser, A.R., Rasmussen, H.H., Schneider, S.M., Thibault, R., Visschers, R.G., Shaffer, J, Klek, S., Forbes, A., Gabe, S., Holst, M., Wanten, G.J.A., Irtun, O., Damink, S.O., Panisic-Sekeljic, M., Pelaez, R.B., Pironi, L, Blaser, A.R., Rasmussen, H.H., Schneider, S.M., Thibault, R., Visschers, R.G., and Shaffer, J

Abstract

Contains fulltext : 165702.pdf (publisher's version ) (Closed access), Intestinal failure (IF) is the consequence of a reduction of gut function below the minimum necessary for the absorption of nutrients from the gastrointestinal tract. Types I and II comprise acute intestinal failure (AIF). Although its prevalence is relatively low, type II AIF is serious and requires specialist multidisciplinary care, often for prolonged periods before its resolution. The key aspects are: sepsis control, fluid and electrolyte resuscitation, optimization of nutritional status, wound care, appropriate surgery and active rehabilitation. The ESPEN Acute Intestinal Failure Special Interest Group (AIF SIG) has devised this position paper to provide a state-of-the-art overview of the management of type II AIF and to point out areas for future research.

Published
2016

44. ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults

Author

Pironi, L, Arends, J., Baxter, J., Bozzetti, F., Pelaez, R.B., Cuerda, C., Forbes, A., Gabe, S., Gillanders, L., Holst, M., Jeppesen, P.B., Joly, F., Kelly, D., Klek, S., Irtun, O., Damink, S.W. Olde, Panisic, M., Rasmussen, H.H., Staun, M., Szczepanek, K., Gossum, A. van, Wanten, G.J.A., Schneider, S.M., Shaffer, J, Pironi, L, Arends, J., Baxter, J., Bozzetti, F., Pelaez, R.B., Cuerda, C., Forbes, A., Gabe, S., Gillanders, L., Holst, M., Jeppesen, P.B., Joly, F., Kelly, D., Klek, S., Irtun, O., Damink, S.W. Olde, Panisic, M., Rasmussen, H.H., Staun, M., Szczepanek, K., Gossum, A. van, Wanten, G.J.A., Schneider, S.M., and Shaffer, J

Abstract

Contains fulltext : 155093.pdf (publisher's version ) (Open Access), BACKGROUND & AIMS: Intestinal failure (IF) is not included in the list of PubMed Mesh terms, as failure is the term describing a state of non functioning of other organs, and as such is not well recognized. No scientific society has yet devised a formal definition and classification of IF. The European Society for Clinical Nutrition and Metabolism guideline committee endorsed its "home artificial nutrition and chronic IF" and "acute IF" special interest groups to write recommendations on these issues. METHODS: After a Medline Search, in December 2013, for "intestinal failure" and "review"[Publication Type], the project was developed using the Delphi round methodology. The final consensus was reached on March 2014, after 5 Delphi rounds and two live meetings. RESULTS: The recommendations comprise the definition of IF, a functional and a pathophysiological classification for both acute and chronic IF and a clinical classification of chronic IF. IF was defined as "the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth". CONCLUSIONS: This formal definition and classification of IF, will facilitate communication and cooperation among professionals in clinical practice, organization and management, and research.

Published
2015

47. 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

48. 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

49. Randomised clinical trial: 2% taurolidine versus 0.9% saline locking in patients on home parenteral nutrition

Author

Henrik Højgaard Rasmussen, Palle Jeppesen, Yannick Wouters, Siri Tribler, Loris Pironi, Pierre Singer, Farooq Rahman, Lars Vinter-Jensen, Geert J. A. Wanten, Miryam Theilla, Wouters, Y., Theilla, M., Singer, P., Tribler, S., Jeppesen, P.B., Pironi, L., Vinter-Jensen, L., Rasmussen, H.H., Rahman, F., and Wanten, G.J.A.

Subjects
Adult, Male, 0301 basic medicine, Taurine, medicine.medical_treatment, Population, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], Bacteremia, Equivalence Trials as Topic, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, All institutes and research themes of the Radboud University Medical Center, Double-Blind Method, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Adverse effect, education, Saline, Aged, education.field_of_study, 030109 nutrition & dietetics, Thiadiazines, Hepatology, business.industry, Gastroenterology, Health Care Costs, Middle Aged, Taurolidine, Clinical trial, Catheter, Parenteral nutrition, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], chemistry, Catheter-Related Infections, Relative risk, Anesthesia, Health Resources, Female, Saline Solution, Parenteral Nutrition, Home, business
Abstract

BACKGROUND: The catheter lock solutions 2% taurolidine and 0.9% saline are both used to prevent catheter-related bloodstream infections (CRBSIs) in home parenteral nutrition patients.AIMS: To compare the effectiveness and safety of taurolidine and saline.METHODS: This multicentre double-blinded trial randomly assigned home parenteral nutrition patients to use either 2% taurolidine or 0.9% saline for 1 year. Patients were stratified in a new catheter group and a pre-existing catheter group. Primary outcome was the rate of CRBSIs/1000 catheter days in the new catheter group and pre-existing catheter group, separately.RESULTS: We randomised 105 patients, of which 102 were analysed as modified intention-to-treat population. In the new catheter group, rates of CRBSIs/1000 catheter days were 0.29 and 1.49 in the taurolidine and saline arm respectively (relative risk, 0.20; 95% CI, 0.04-0.71; P = 0.009). In the pre-existing catheter group, rates of CRBSIs/1000 catheter days were 0.39 and 1.32 in the taurolidine and saline arm respectively (relative risk, 0.30; 95% CI, 0.03-1.82; P = 0.25). Excluding one outlier patient in the taurolidine arm, mean costs per patient were $1865 for taurolidine and $4454 for saline (P = 0.03). Drug-related adverse events were rare and generally mild.CONCLUSIONS: In the new catheter group, taurolidine showed a clear decrease in CRBSI rate. In the pre-existing catheter group, no superiority of taurolidine could be demonstrated, most likely due to underpowering. Overall, taurolidine reduced the risk for CRBSIs by more than four times. Given its favourable safety and cost profile, taurolidine locking should be considered as an additional strategy to prevent CRBSIs.TRIAL REGISTRATION: Clinicaltrials.gov, identifier: NCT01826526.

Published
2018

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