Avoiding the use of long-term parenteral support in patients without intestinal failure: A position paper from the European Society of Clinical Nutrition & Metabolism, the European Society of Neurogastroenterology and Motility and the Rome Foundation for Disorders of Gut-Brain Interaction.

Autor: Lal S; National Intestinal Failure Reference Centre, Northern Care Alliance and University of Manchester, Salford, Manchester, UK., Paine P; Department of Gastroenterology, Northern Care Alliance and University of Manchester, Salford, Manchester, UK., Tack J; Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium.; Rome Foundation, Raleigh, North Carolina, USA., Aziz Q; Blizard Institute, Wingate Institute for Neurogastroenterology, Centre for Neuroscience, Surgery and Trauma, Queen Mary University of London, London, UK., Barazzoni R; Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy., Cuerda C; Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Jeppesen P; Department of Gastroenterology, Rigshospitalet, Copenhagen, Denmark., Joly F; Department of Gastroenterology and Nutritional Support, Center for Intestinal Failure, Reference Centre of Rare Disease MarDI, AP-HP Beaujon Hospital, University of Paris Inserm UMR, Paris, France., Lamprecht G; Division of Gastroenterology and Endocrinology, Department of Medicine II, Rostock University Medical Center, Rostock, Germany., Mundi M; Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA., Schneider S; Gastroenterology and Nutrition, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France., Szczepanek K; General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland., Van Gossum A; Medico-Surgical Department of Gastroenterology, Hôpital Erasme, Free University of Brussels, Brussels, Belgium., Wanten G; Intestinal Failure Unit, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands., Vanuytsel T; Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium., Pironi L; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.; Centre for Chronic Intestinal Failure, IRCCS AOUBO, Bologna, Italy.
Jazyk: angličtina
Zdroj: Neurogastroenterology and motility [Neurogastroenterol Motil] 2024 Sep; Vol. 36 (9), pp. e14853. Date of Electronic Publication: 2024 Jul 08.
DOI: 10.1111/nmo.14853
Abstrakt: The role of long-term parenteral support in patients with underlying benign conditions who do not have intestinal failure (IF) is contentious, not least since there are clear benefits in utilising the oral or enteral route for nutritional support. Furthermore, the risks of long-term home parenteral nutrition (HPN) are significant, with significant impacts on morbidity and mortality. There has, however, been a recent upsurge of the use of HPN in patients with conditions such as gastro-intestinal neuromuscular disorders, opioid bowel dysfunction, disorders of gut-brain interaction and possibly eating disorders, who do not have IF. As a result, the European Society of Clinical Nutrition and Metabolism (ESPEN), the European Society of Neuro-gastroenterology and Motility (ESNM) and the Rome Foundation for Disorders of Gut Brain Interaction felt that a position statement is required to clarify - and hopefully reduce the potential for harm associated with - the use of long-term parenteral support in patients without IF. Consensus opinion is that HPN should not be prescribed for patients without IF, where the oral and/or enteral route can be utilised. On the rare occasions that PN commencement is required to treat life-threatening malnutrition in conditions such as those listed above, it should only be prescribed for a time-limited period to achieve nutritional safety, while the wider multi-disciplinary team focus on more appropriate biopsychosocial holistic and rehabilitative approaches to manage the patient's primary underlying condition.
(© 2024 The Author(s). Neurogastroenterology & Motility published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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