Home central venous hyperalimentation in fifteen patients with severe scleroderma bowel disease

Abstract

Fifteen patients with severe scleroderma bowel disease began receiving home central venous hyperalimentation (HCVH) between 1979 and 1987. The major reasons for instituting HCVH were intestinal pseudoobstruction, malabsorption, and malnutrition. Eleven patients had an improved quality of life. Serious complications encountered over these 15,700 catheter-use days were 2 episodes of septicemia and 2 episodes of superior vena cava obstruction. Seven patients died, but none directly from their gastrointestinal disease or from the HCVH.Small bowel involvement, with diminished small bowel motility, has been reported to occur in about 40% of patients with scleroderma (I). The hypomotility of the small intestine can lead to malabsorption and intestinal pseudoobstruction, which can result in death (2).

Outcome on home parenteral nutrition for benign intestinal failure: A review of the literature and benchmarking with the European prospective survey of ESPEN

“…20,31e33,36,40e42 Patients with systemic sclerosis (SSc) had the poorest outcome of 57% survival at 3 years. 46 20,23,31e33,37,41,42 or radiation enteritis, 20,23,31,32,37,41e45 with approximately 60% surviving at 5 years. The survival rate of patients with intra-abdominal desmoids in familial polyposis depends on the stage of the tumor; the 10-year survival for mild, moderate, or severe stage disease, was 95%, 85% and 65%, respectively.…”

Quality of life measurement in gastrointestinal and liver disorders

“…HRQOL has been assessed in several other chronic GID such as patients with short bowel symdrome receiving home parenteral nutrition (HPN),9 113 114 and those with gastroparesis,115 116 achalasia,117 and chronic intestinal bleeding,118 and appears to be impaired in all of these disorders. Patients receiving HPN had significantly worse IBDQ scores (mean 5.0 v 5.6, respectively; p<0.05) and SIP scores (mean 17% v 8%, respectively (higher scores worse); p<0.001) than patients with short bowel who were not receiving HPN.…”

Nutrition Management in Patients With Chronic Gastrointestinal Motility Disorders: A Systematic Literature Review

“…The 2 other studies retrospectively analyzed cases that prescribed home parenteral nutrition . Quality scores show that the most recent study has a low risk of bias, though the other had poorly reported outcomes .…”