Nutritional support in patients with gastrointestinal fistula

Yanar, Fatih; Yanar, Hakan

doi:10.1007/s00068-011-0105-6

Cited by 17 publications

(17 citation statements)

References 22 publications

(32 reference statements)

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“…Observational studies performed between 1990 and 2016 report goal energy doses at 25–30 kcal/kg/d and goal protein doses at 1.5 g/kg/d but do not report actual intake levels relative to important clinical outcomes (Supplemental Table S3) 16 , 17 , 25 , 27 , 28 . Three recent review articles recommend a protein dose of 1.5 g/kg/d and kcal to meet basal energy expenditure in patients with low‐output ECF and increasing protein dose to 1.5–2.5 g/kg/d and calorie dose to 1.5–2 times basal energy expenditure in patients with high‐output ECF 29 . ‐ 31 None of the available review articles comment on application to obese patients with ECF, although this represents a significant percentage of the patient population.…”

Section: Resultsmentioning

confidence: 99%

ASPEN‐FELANPE Clinical Guidelines

Kumpf

Aguilar-Nascimento

Graf

et al. 2016

J Parenter Enteral Nutr

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In adult patients with enterocutaneous fistula: (1) What factors best describe nutrition status? (2) What is the preferred route of nutrition therapy (oral diet, enteral nutrition, or parenteral nutrition)? (3) What protein and energy intake provide best clinical outcomes? (4) Is fistuloclysis associated with better outcomes than standard care? (5) Are immune-enhancing formulas associated with better outcomes than standard formulas? (6) Does the use of somatostatin or somatostatin analogue provide better outcomes than standard medical therapy? (7) When is home parenteral nutrition support indicated?

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Section: Resultsmentioning

confidence: 99%

ASPEN‐FELANPE Clinical Guidelines

Kumpf

Aguilar-Nascimento

Graf

et al. 2016

J Parenter Enteral Nutr

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“…Various research studies support the role of dietitians in improving patient outcomes. 7,[9][10][11]16,17 In particular, dietary interventions by nutritional supplementation, individualised dietary counselling or a combination of both have been shown to increase patients' energy and protein intakes, influence overall nutritional status and also lead to an improvement in clinical outcomes. 11 Dietary counselling alone has been found to have an impact on outcomes.…”

Section: Discussionmentioning

confidence: 99%

Dietetic intervention for inpatients on fluid‐only diets helps to achieve nutritional requirements

Deacon

Moran

Laskey‐Gilboy

et al. 2017

Nutrition & Dietetics

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This study shows that dietetic intervention enabled patients on fluid-only diets to meet up to 80% more of their energy requirements and up to 95% more of their protein requirements. These results were consistent across age, BMI and fluid diet type. The significance of these differences has resulted in a change of clinical practice at the study hospital. All patients on fluid-only diets for three days or longer are now blanket referred for dietetic intervention.

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“…Conservative treatment was used to build up nutritional status, stabilize the patient before surgery, improve the surgical outcome, and decrease the risk of postoperative complications 11. A subjective global assessment was available for nine cases; seven were malnourished, indicating that this assessment was performed only for such cases.…”

Section: Discussionmentioning

confidence: 99%

“…It includes total parenteral nutrition (TPN), enteral feeding, or oral feeding, and plays a major role in management of enterocutaneous fistula 8–10. It begins with calculating calories and protein requirements, assessing tolerance of the feeding regimen, modifying feeding methods, adjusting nutritional requirements according to changes in clinical status, and finally, observing for feeding complications 11. Classification of the fistula affects the route of feeding and caloric and protein requirements;12 ie, patients with high output fistula should receive more calories and protein than those with low output fistula who mostly require TPN.…”

Section: Introductionmentioning

confidence: 99%

Nutritional management of enterocutaneous fistula: a retrospective study at a Malaysian university medical center

Badrasawi¹,

Shahar²,

Sagap³

2014

JMDH

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Enterocutaneous fistula is a challenging clinical condition with serious complications and considerable morbidity and mortality. Early nutritional support has been found to decrease these complications and to improve the clinical outcome. Location of the fistula and physiological status affect the nutrition management plan in terms of feeding route, calories, and protein requirements. This study investigated the nutritional management procedures at the Universiti Kebangsaan Malaysia Medical Center, and attempted to determine factors that affect the clinical outcome. Nutritional management was evaluated retrospectively in 22 patients with enterocutaneous fistula seen over a 5-year period. Medical records were reviewed to obtain data on nutritional status, biochemical indices, and route and tolerance of feeding. Calories and protein requirements are reported and categorized. The results show that surgery was the predominant etiology and low output fistula was the major physiological category; anatomically, the majority were ileocutaneous. The spontaneous healing rate was 14%, the total healing rate was 45%, and the mortality rate was 22%, with 14% due to fistula-associated complications. There was a significant relationship between body mass index/serum albumin levels and fistula healing; these parameters also had a significant relationship with mortality. Glutamine was used in 50% of cases; however, there was no significant relationship with fistula healing or mortality rate. The nutritional status of the patient has an important impact on the clinical outcome. Conservative management that includes nutrition support is very important in order to improve nutritional status before surgical repair of the fistula.

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Nutritional support in patients with gastrointestinal fistula

Cited by 17 publications

References 22 publications

ASPEN‐FELANPE Clinical Guidelines

ASPEN‐FELANPE Clinical Guidelines

Dietetic intervention for inpatients on fluid‐only diets helps to achieve nutritional requirements

Nutritional management of enterocutaneous fistula: a retrospective study at a Malaysian university medical center

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