Organization and outcomes of multidisciplinary intestinal failure teams

Javid, Patrick J.; Wendel, Danielle; Horslen, Simon

doi:10.1053/j.sempedsurg.2018.07.005

Cited by 29 publications

(22 citation statements)

References 31 publications

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“…For adults on HPN, the core members of an NST should be a physician, nutrition nurse specialist, senior dietitian, and senior clinical pharmacist, according to the ESPEN guidelines [43]. In Table 3 a suggestion for the composition of an NST for both pediatric and adult patients on HPN is given including the minimal designated roles of each team member [32,43,46,48,49]. The goal of an NST should be to provide both physical and psychological support for patients on HPN and their caregivers.…”

Section: Of 14mentioning

confidence: 99%

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The Role of a Nutrition Support Team in the Management of Intestinal Failure Patients

et al. 2020

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Parenteral nutrition (PN) is a complex and specialized form of nutrition support that has revolutionized the care for both pediatric and adult patients with acute and chronic intestinal failure (IF). This has led to the development of multidisciplinary teams focused on the management of patients receiving PN: nutrition support teams (NSTs). In this review we aim to discuss the historical aspects of IF management and NST development, and the practice, composition, and effectiveness of multidisciplinary care by NSTs in patients with IF. We also discuss the experience of two IF centers as an example of contemporary NSTs at work. An NST usually consists of at least a physician, nurse, dietitian, and pharmacist. Multidisciplinary care by an NST leads to fewer complications including infection and electrolyte disturbances, and better survival for patients receiving short- and long-term PN. Furthermore, it leads to a decrease in inappropriate prescriptions of short-term PN leading to significant cost reduction. Complex care for patients receiving PN necessitates close collaboration between team members and NSTs from other centers to optimize safety and effectiveness of PN use.

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Section: Of 14mentioning

confidence: 99%

“…Table 3. Suggested members of a nutrition support team for patients on home parenteral nutrition and their minimal designated roles [32,43,46,48,49].…”

Section: Improved Outcomes With Nutrition Support Teamsmentioning

confidence: 99%

The Role of a Nutrition Support Team in the Management of Intestinal Failure Patients

et al. 2020

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“…9,10 Considering this, IRPs are associated not only with decreased mortality and morbidities as previously described, but also with improvement of intestinal adaptation and outcomes of autologous bowel reconstruction procedures. 8,[10][11][12][13] Thus, understanding mechanisms of intestinal adaptation is essential and is required to propose the most accurate medical and surgical strategies to each patient with SBS. 2,[14][15][16] The available approaches to potentiate intestinal adaptation include nutritional strategies, pharmacologic agents and surgery.…”

Section: Discussionmentioning

confidence: 99%

European Pediatric Surgeon' Association Survey on the Management of Short-Bowel Syndrome

et al. 2020

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Introduction The aim of this study was to assess the management of short-bowel syndrome (SBS) at the time of primary surgery, and the strategies used to facilitate enteral autonomy depending on the institutional expertise. Materials and Methods An online questionnaire was sent in 2019 to members of The European Pediatric Surgeons' Association. Results Among the 65 responding members (26 countries, 85% from university hospitals), 57% manage less than three new patients with SBS per year (group A), and 43% at least three patients (group B). The cut-off of three patients treated yearly used in our study was defined after statistical analysis of different cut-offs. A multidisciplinary intestinal rehabilitation program is significantly more frequent in group B than in group A (85 and 53%, respectively; p = 0.009). Considering the primary surgical management of multiple intestinal atresia and congenital ultra-short bowel with jejunal atresia, primary surgical strategies to optimize bowel length are more often used in group B than group A (p = 0.09 and p = 0.04, respectively). A minimum of one intestinal lengthening procedure every 2 to 3 years is significantly more frequent in group B than group A (95 and 45%, respectively; p = 0.0013). Among the strategies used to promote intestinal adaptation, group B (35%) uses significantly more often glucagon-like peptide 2 analogs than group A (10%) (p = 0.02). Conclusion Based on our survey, a minimum number of SBS patients treated yearly is required to manage this challenging disease according to up-to-date medical and surgical strategies. However, whatever their level of expertise is in managing SBS, most of pediatric surgeons are involved in the primary surgery. Medical education programs about SBS should be more largely available to pediatric surgeons.

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“…Aunque se reconozca la insuficiencia, esta no se asocia con una posible situación de avance de la misma a falla, y tampoco a la desnutrición generada por la disminución en el aporte nutricional, al que frecuentemente son sometidos estos pacientes. A pesar de esto, la presencia de los síntomas de insuficiencia intestinal no implica necesariamente el avance de la misma hacia la falla (18,19) .…”

Section: La Doble Vía: De La Insuficiencia a La Falla Intestinalunclassified

De la insuficiencia a la falla intestinal, un camino de doble sentido que cruza con la malnutrición

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Narváez-Solarte

2021

Rev. Nutr. Clin. Metab.

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Introducción: actualmente, la insuficiencia y la falla intestinal están presentes en cerca del 60 % de los pacientes en unidades de cuidado intensivo en el mundo, siendo más frecuente la presencia de insuficiencia. El objetivo de esta revisión es presentar la evidencia actual sobre la relación de la insuficiencia, la falla intestinal y su influencia en el desarrollo de la malnutrición hospitalaria. Métodos: se realizó una búsqueda en Medline y PubMed de las publicaciones que incluyeran las palabras clave “insuficiencia intestinal”, “falla intestinal”, “soporte nutricional”, “malnutrición hospitalaria”, de artículos en inglés y español. Resultados: la presencia de falla e insuficiencia intestinal aumenta la probabilidad de malnutrición en el paciente en estado crítico debido a que la absorción de nutrientes se ve disminuida y, por ende, lo hace más vulnerable a desarrollar una mayor pérdida de peso, lo que aumenta su morbimortalidad. Además, la estancia hospitalaria de los pacientes es más prolongada, y genera altos costos al sistema de salud. Esto se debe a que frecuentemente se presentan infecciones y complicaciones asociadas con la desnutrición y la pérdida de productividad, lo que disminuye la calidad de vida, con efectos negativos sobre el entorno social. Conclusiones: la insuficiencia y falla intestinal son situaciones que pueden generarse de manera bidireccional. Las diferencias en la clasificación de la falla intestinal según las diversas asociaciones afectan el manejo de los pacientes. Palabras clave: insuficiencia intestinal, falla intestinal, soporte nutricional, malnutrición hospitalaria.

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Organization and outcomes of multidisciplinary intestinal failure teams

Cited by 29 publications

References 31 publications

The Role of a Nutrition Support Team in the Management of Intestinal Failure Patients

The Role of a Nutrition Support Team in the Management of Intestinal Failure Patients

European Pediatric Surgeon' Association Survey on the Management of Short-Bowel Syndrome

De la insuficiencia a la falla intestinal, un camino de doble sentido que cruza con la malnutrición

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