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

Loris Pironi, Jann Arends, Janet Baxter, Federico Bozzetti, Rosa Burgos Peláez, Cristina Cuerda, Alastair Forbes, Simon Gabe, Lyn Gillanders, Mette Holst, Palle Bekker Jeppesen, Francisca Joly, Darlene Kelly, Stanislaw Klek, Øivind Irtun, Sw Olde Damink, Marina Panisic, Henrik Højgaard Rasmussen, Michael Staun, Kinga SzczepanekAndré Van Gossum, Geert Wanten, Stéphane Michel Schneider, Jon Shaffer

Research output: Contribution to journalArticlepeer-review

457 Citations (Scopus)


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.

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.

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”.

This formal definition and classification of IF, will facilitate communication and cooperation among professionals in clinical practice, organization and management, and research.
Original languageEnglish
Article number25311444
Pages (from-to)171-180
Number of pages10
JournalClinical Nutrition
Issue number2
Early online date21 Sep 2014
Publication statusPublished - Apr 2015


  • intestinal failure
  • HPN
  • TPN
  • Short bowel syndrome
  • Chronic intestinal pseudo-obstruction
  • Enterocutaneous fistulas
  • Home parenteral nutrition
  • Intestinal transplantation

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