Abstract
Intestinal failure is the reduction in gut function below the minimum necessary for the absorption of macronutrients and/or water electrolytes. The based treatment for type II and III intestinal failure patients is home parenteral nutrition (HPN) and hydration (HPH). This is a case-series study of HPN/HPH patients of the Hospital Garcia de Orta, Portugal, where thirteen patients present different underlying disorders and various IVS needs of nutrition and/or hydration. Most presented type III failure and most of them survived a long period under HPN and/or HNH.
1. Introduction
The European Society for Clinical Nutrition and Metabolism (ESPEN) defines intestinal failure as the reduction in gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation (IVS) is required to maintain health and/or growth []. On a pathophysiological perspective, intestinal failure might be divided in three types: type I, short term, with IVS over a period of days/weeks; type II, a long-term subacute condition where IVS is maintained for weeks/months; type III, a chronic condition, in which IVS is required over months/years []. Conversely, the clinical classification is based on the IVS requirements of energy and volume; from A to D as the energy IVS, and from 1 to 4 as the volume of the IVS []. Although oral nutrient intake is possible in most individuals with intestinal failure, home parenteral nutrition (HPN) and/or hydration (HPH) remain the base of treatment, to prevent malabsorption-associated morbidity. Intestinal failure patients with type II and type III need a multi-disciplinary care, which is given in the Hospital Garcia de Orta. The aim of this study is to evaluate the effectiveness of HPN and HPH in the treatment and prognostic of intestinal failure.
2. Materials and Methods
This study was a case-series study of HPN/HPH patients of the Hospital Garcia de Orta, Almada, Portugal. All clinical files of long-term HPN/HPH patients were selected. The only exclusion criteria was an incomplete file. The present study is a sub-analysis of a large study approved by the ethical committee and the administration of our hospital.
3. Results and Discussion
This study is based on the data of thirteen clinical files, organized and presented in Table 1.
Table 1.
Thirteen patients were eligible for this study and classified under the aforementioned criteria.
Most patients presented type III failure and the majority survived the home parenteral nutrition and/or hydration long period, therefore indicating that these, in fact, are effective forms of treatment for intestinal failure. The deaths observed were most likely due to concomitant morbidities.
Institutional Review Board Statement
Not applicable.
Informed Consent Statement
Not applicable.
Data Availability Statement
Not applicable.
Conflicts of Interest
The authors declare no conflict of interest.
References
- Pironi, L.; Arends, J.; Baxter, J.; Bozzetti, F.; Peláez, R.B.; Cuerda, C.; Forbes, A.; Gabe, S.; Gillanders, L.; Holst, M.; et al. ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults. Clin. Nutr. 2015, 34, 171–180. [Google Scholar] [CrossRef] [PubMed]
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