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 Wanten; Cécile Chambrier; Umberto  Aimasso; Anna Simona  Sasdelli; Kinga Szczepanek; Amelia  Jukes; Simona  Di Caro; Miriam  Theilla; Marek  Kunecki; Joanne  Daniels; Mireille  Serlie; Florian  Poullenot; Sheldon C. Cooper; Henrik Højgaard Rasmussen; Charlene Compher; Adriana  Crivelli; Sarah-Jane  Hughes; Francesco W.  Guglielmi; Nada  Rotovnik Kozjek; Stéphane M.  Schneider; Lars  Ellegard; Ronan Thibault; Przemysław  Matras; Anna  Zmarzly; Konrad  Matysiak; André van Gossum; Alastair Forbes; Nicola  Wyer; Marina  Taus; Nuria M.  Virgili; Margie O'Callaghan; Brooke  Chapman; Emma  Osland; Cristina Cuerda; Peter  Sahin; Lynne Jones; Andre Dong Won Lee; Luisa  Masconale; Paolo  Orlandoni; Corrado  Spaggiari; Maryana  Doitchinova-Simeonova; Carmen  Garde; Aurora E.  Serralde-Zúñiga; Gabriel  Olveira; Zeljko Krznaric; Estrella  Petrina Jáuregui; Ana  Zugasti Murillo; José P. Suárez-Llanos; 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 Wanten, Cécile Chambrier, Umberto Aimasso, Anna Simona Sasdelli, Kinga Szczepanek, Amelia Jukes, Simona Di Caro, Miriam Theilla, Marek Kunecki, Joanne Daniels, Mireille Serlie, Florian Poullenot, Sheldon C. Cooper, Henrik Højgaard Rasmussen, Charlene Compher, Adriana Crivelli, Sarah-Jane HughesFrancesco W. Guglielmi, Nada Rotovnik Kozjek, Stéphane M. Schneider, Lars Ellegard, Ronan Thibault, Przemysław Matras, Anna Zmarzly, Konrad Matysiak, André van Gossum, Alastair Forbes, Nicola Wyer, Marina Taus, Nuria M. Virgili, Margie O'Callaghan, Brooke Chapman, Emma Osland, Cristina Cuerda, Peter Sahin, Lynne Jones, Andre Dong Won Lee, Luisa Masconale, Paolo Orlandoni, Corrado Spaggiari, Maryana Doitchinova-Simeonova, Carmen Garde, Aurora E. Serralde-Zúñiga, Gabriel Olveira, Zeljko Krznaric, Estrella Petrina Jáuregui, Ana Zugasti Murillo, José P. Suárez-Llanos, 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
Pages (from-to)	1787-1795
Number of pages	9
Journal	Gut
Volume	69
Issue number	10
Early online date	21 Jan 2020
DOIs	https://doi.org/10.1136/gutjnl-2018-318172
Publication status	Published - 1 Oct 2020

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Pironi, L., Steiger, E., Joly, F., Wanten, G., Chambrier, C., Aimasso, U., Sasdelli, A. S., Szczepanek, K., Jukes, A., Di Caro, S., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Cooper, S. C., Rasmussen, H. H., Compher, C., Crivelli, 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, 69(10), 1787-1795. https://doi.org/10.1136/gutjnl-2018-318172

@article{8e33ef07c885452ea0764bd363590ea6,

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.",

author = "Loris Pironi and Ezra Steiger and Francisca Joly and Geert Wanten and C{\'e}cile Chambrier and Umberto Aimasso and Sasdelli, {Anna Simona} and Kinga Szczepanek and Amelia Jukes and {Di Caro}, Simona and Miriam Theilla and Marek Kunecki and Joanne Daniels and Mireille Serlie and Florian Poullenot and Cooper, {Sheldon C.} and Rasmussen, {Henrik H{\o}jgaard} and Charlene Compher and Adriana Crivelli and Sarah-Jane Hughes and Guglielmi, {Francesco W.} and {Rotovnik Kozjek}, Nada and Schneider, {St{\'e}phane M.} and Lars Ellegard and Ronan Thibault and Przemys{\l}aw Matras and Anna Zmarzly and Konrad Matysiak and {van Gossum}, Andr{\'e} and Alastair Forbes and Nicola Wyer and Marina Taus and Virgili, {Nuria M.} and Margie O'Callaghan and Brooke Chapman and Emma Osland and Cristina Cuerda and Peter Sahin and Lynne Jones and {Dong Won Lee}, Andre and Luisa Masconale and Paolo Orlandoni and Corrado Spaggiari and Maryana Doitchinova-Simeonova 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 Simon Lal",

year = "2020",

month = oct,

day = "1",

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

language = "English",

volume = "69",

pages = "1787--1795",

journal = "Gut",

issn = "0017-5749",

publisher = "BMJ Publishing Group",

number = "10",

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Pironi, L, Steiger, E, Joly, F, Wanten, G, Chambrier, C, Aimasso, U, Sasdelli, AS, Szczepanek, K, Jukes, A, Di Caro, S, Theilla, M, Kunecki, M, Daniels, J, Serlie, M, Poullenot, F, Cooper, SC, Rasmussen, HH, Compher, C, Crivelli, A, Hughes, S-J, Guglielmi, FW, Rotovnik Kozjek, N, Schneider, SM, Ellegard, L, Thibault, R, Matras, P, Zmarzly, A, Matysiak, K, van Gossum, A, Forbes, A, Wyer, N, Taus, M, Virgili, NM, O'Callaghan, M, Chapman, B, Osland, E, Cuerda, C, Sahin, P, Jones, L, Dong Won Lee, A, Masconale, L, Orlandoni, P, Spaggiari, C, Doitchinova-Simeonova, M, Garde, C, Serralde-Zúñiga, AE, Olveira, G, Krznaric, Z, Petrina Jáuregui, E, Zugasti Murillo, A, Suárez-Llanos, JP & 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, 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

AU - Chambrier, Cécile

AU - Aimasso, Umberto

AU - Sasdelli, Anna Simona

AU - Szczepanek, Kinga

AU - Jukes, Amelia

AU - Di Caro, Simona

AU - Theilla, Miriam

AU - Kunecki, Marek

AU - Daniels, Joanne

AU - Serlie, Mireille

AU - Poullenot, Florian

AU - Cooper, Sheldon C.

AU - Rasmussen, Henrik Højgaard

AU - Compher, Charlene

AU - Crivelli, Adriana

AU - Hughes, Sarah-Jane

AU - Guglielmi, Francesco W.

AU - Rotovnik Kozjek, Nada

AU - Schneider, Stéphane M.

AU - Ellegard, Lars

AU - Thibault, Ronan

AU - Matras, Przemysław

AU - Zmarzly, Anna

AU - Matysiak, Konrad

AU - van Gossum, André

AU - Forbes, Alastair

AU - Wyer, Nicola

AU - Taus, Marina

AU - Virgili, Nuria M.

AU - O'Callaghan, Margie

AU - Chapman, Brooke

AU - Osland, Emma

AU - Cuerda, Cristina

AU - Sahin, Peter

AU - Jones, Lynne

AU - Dong Won Lee, Andre

AU - Masconale, Luisa

AU - Orlandoni, Paolo

AU - Spaggiari, Corrado

AU - Doitchinova-Simeonova, Maryana

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 - Lal, Simon

PY - 2020/10/1

Y1 - 2020/10/1

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.

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 - Article

VL - 69

SP - 1787

EP - 1795

JO - Gut

JF - Gut

SN - 0017-5749

IS - 10

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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