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

Loris Pironi; Ezra Steiger; Francisca Joly; Geert J A Wanten; Cecile Chambrier; Umberto Aimasso; Anna Simona Sasdelli; Kinga Szczepanek; Amelia Jukes; Miriam Theilla; Marek Kunecki; Joanne Daniels; Mireille J Serlie; Sheldon C Cooper; Florian Poullenot; Henrik Højgaard Rasmussen; Charlene W Compher; Adriana Crivelli; Sarah-Jane Hughes; Lidia Santarpia; Francesco William Guglielmi; Nada Rotovnik Kozjek; Lars Ellegard; Stéphane M Schneider; Przemysław Matras; Alastair Forbes; Nicola Wyer; Anna Zmarzly; Marina Taus; Margie O'Callaghan; Emma Osland; Ronan Thibault; Cristina Cuerda; Lynn Jones; Brooke Chapman; Peter Sahin; Núria M Virgili; Andre Dong Won Lee; Paolo Orlandoni; Konrad Matysiak; Simona Di Caro; Maryana Doitchinova-Simeonova; Luisa Masconale; Corrado Spaggiari; Carmen Garde; Aurora E Serralde-Zúñiga; Gabriel Olveira; Zeljko Krznaric; Estrella Petrina Jáuregui; Ana Zugasti Murillo; José P Suárez-Llanos; Elena Nardi; André Van Gossum; Simon Lal

doi:10.1136/gutjnl-2018-318172

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

Loris Pironi, Ezra Steiger, Francisca Joly, Geert J A Wanten, Cecile Chambrier, Umberto Aimasso, Anna Simona Sasdelli, Kinga Szczepanek, Amelia Jukes, Miriam Theilla, Marek Kunecki, Joanne Daniels, Mireille J Serlie, Sheldon C Cooper, Florian Poullenot, Henrik Højgaard Rasmussen, Charlene W Compher, Adriana Crivelli, Sarah-Jane Hughes, Lidia SantarpiaFrancesco William Guglielmi, Nada Rotovnik Kozjek, Lars Ellegard, Stéphane M Schneider, Przemysław Matras, Alastair Forbes, Nicola Wyer, Anna Zmarzly, Marina Taus, Margie O'Callaghan, Emma Osland, Ronan Thibault, Cristina Cuerda, Lynn Jones, Brooke Chapman, Peter Sahin, Núria M Virgili, Andre Dong Won Lee, Paolo Orlandoni, Konrad Matysiak, Simona Di Caro, Maryana Doitchinova-Simeonova, Luisa Masconale, Corrado Spaggiari, Carmen Garde, Aurora E Serralde-Zúñiga, Gabriel Olveira, Zeljko Krznaric, Estrella Petrina Jáuregui, Ana Zugasti Murillo, José P Suárez-Llanos, Elena Nardi, André Van Gossum, Simon Lal

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Abstract

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.

Original language	English
Article number	318172
Journal	Gut
Volume	69
Issue number	10
Pages (from-to)	1787-1795
Number of pages	9
ISSN	0017-5749
DOIs	https://doi.org/10.1136/gutjnl-2018-318172
Publication status	Published - Oct 2020

Keywords

intestinal failure
liver failure
motility disorders
parenteral nutrition
short bowel syndrome

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10.1136/gutjnl-2018-318172

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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., ... Lal, S. (2020). Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure. Gut, 69(10), 1787-1795. Article 318172. Advance online publication. https://doi.org/10.1136/gutjnl-2018-318172

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

abstract = "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.",

keywords = "intestinal failure, liver failure, motility disorders, parenteral nutrition, short bowel syndrome",

author = "Loris Pironi and Ezra Steiger and Francisca Joly and Wanten, {Geert J A} and Cecile Chambrier and Umberto Aimasso and Sasdelli, {Anna Simona} and Kinga Szczepanek and Amelia Jukes and Miriam Theilla and Marek Kunecki and Joanne Daniels and Serlie, {Mireille J} and Cooper, {Sheldon C} and Florian Poullenot and Rasmussen, {Henrik H{\o}jgaard} and Compher, {Charlene W} and Adriana Crivelli and Sarah-Jane Hughes and Lidia Santarpia and Guglielmi, {Francesco William} and {Rotovnik Kozjek}, Nada and Lars Ellegard and Schneider, {St{\'e}phane M} and Przemys{\l}aw Matras and Alastair Forbes and Nicola Wyer and Anna Zmarzly and Marina Taus and Margie O'Callaghan and Emma Osland and Ronan Thibault and Cristina Cuerda and Lynn Jones and Brooke Chapman and Peter Sahin and Virgili, {N{\'u}ria M} and Lee, {Andre Dong Won} and Paolo Orlandoni and Konrad Matysiak and {Di Caro}, Simona and Maryana Doitchinova-Simeonova and Luisa Masconale and Corrado Spaggiari and Carmen Garde and Serralde-Z{\'u}{\~n}iga, {Aurora E} and Gabriel Olveira and Zeljko Krznaric and {Petrina J{\'a}uregui}, Estrella and {Zugasti Murillo}, Ana and Su{\'a}rez-Llanos, {Jos{\'e} P} and Elena Nardi and {Van Gossum}, Andr{\'e} and Simon Lal",

year = "2020",

month = oct,

doi = "10.1136/gutjnl-2018-318172",

language = "English",

volume = "69",

pages = "1787--1795",

journal = "Gut",

issn = "0017-5749",

publisher = "B M J Group",

number = "10",

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Pironi, L, Steiger, E, Joly, F, Wanten, GJA, Chambrier, C, Aimasso, U, Sasdelli, AS, Szczepanek, K, Jukes, A, Theilla, M, Kunecki, M, Daniels, J, Serlie, MJ, Cooper, SC, Poullenot, F, Rasmussen, HH, Compher, CW, Crivelli, A, Hughes, S-J, Santarpia, L, Guglielmi, FW, Rotovnik Kozjek, N, Ellegard, L, Schneider, SM, 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, NM, Lee, ADW, Orlandoni, P, Matysiak, K, Di Caro, S, Doitchinova-Simeonova, M, Masconale, L, Spaggiari, C, Garde, C, Serralde-Zúñiga, AE, Olveira, G, Krznaric, Z, Petrina Jáuregui, E, Zugasti Murillo, A, Suárez-Llanos, JP, Nardi, E, Van Gossum, A & Lal, S 2020, 'Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure', Gut, vol. 69, no. 10, 318172, pp. 1787-1795. https://doi.org/10.1136/gutjnl-2018-318172

TY - JOUR

T1 - Intravenous supplementation type and volume are associated with 1-year outcome and major complications in patients with chronic intestinal failure

AU - Pironi, Loris

AU - Steiger, Ezra

AU - Joly, Francisca

AU - Wanten, Geert J A

AU - Chambrier, Cecile

AU - Aimasso, Umberto

AU - Sasdelli, Anna Simona

AU - Szczepanek, Kinga

AU - Jukes, Amelia

AU - Theilla, Miriam

AU - Kunecki, Marek

AU - Daniels, Joanne

AU - Serlie, Mireille J

AU - Cooper, Sheldon C

AU - Poullenot, Florian

AU - Rasmussen, Henrik Højgaard

AU - Compher, Charlene W

AU - Crivelli, Adriana

AU - Hughes, Sarah-Jane

AU - Santarpia, Lidia

AU - Guglielmi, Francesco William

AU - Rotovnik Kozjek, Nada

AU - Ellegard, Lars

AU - Schneider, Stéphane M

AU - Matras, Przemysław

AU - Forbes, Alastair

AU - Wyer, Nicola

AU - Zmarzly, Anna

AU - Taus, Marina

AU - O'Callaghan, Margie

AU - Osland, Emma

AU - Thibault, Ronan

AU - Cuerda, Cristina

AU - Jones, Lynn

AU - Chapman, Brooke

AU - Sahin, Peter

AU - Virgili, Núria M

AU - Lee, Andre Dong Won

AU - Orlandoni, Paolo

AU - Matysiak, Konrad

AU - Di Caro, Simona

AU - Doitchinova-Simeonova, Maryana

AU - Masconale, Luisa

AU - Spaggiari, Corrado

AU - Garde, Carmen

AU - Serralde-Zúñiga, Aurora E

AU - Olveira, Gabriel

AU - Krznaric, Zeljko

AU - Petrina Jáuregui, Estrella

AU - Zugasti Murillo, Ana

AU - Suárez-Llanos, José P

AU - Nardi, Elena

AU - Van Gossum, André

AU - Lal, Simon

PY - 2020/10

Y1 - 2020/10

N2 - 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.

AB - 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.

KW - intestinal failure

KW - liver failure

KW - motility disorders

KW - parenteral nutrition

KW - short bowel syndrome

UR - http://www.scopus.com/inward/record.url?scp=85078478975&partnerID=8YFLogxK

U2 - 10.1136/gutjnl-2018-318172

DO - 10.1136/gutjnl-2018-318172

M3 - Journal article

C2 - 31964752

SN - 0017-5749

VL - 69

SP - 1787

EP - 1795

JO - Gut

JF - Gut

IS - 10

M1 - 318172

ER -

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

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