Intestinal failure requires the placement and maintenance of a long-term central venous catheter for the provision of fluids and/or nutrients. Complications associated with this access contribute to significant morbidity and mortality, while the loss of access is an increasingly common reason for intestinal transplant referral. As more emphasis has been placed on the prevention of central line-associated bloodstream infections and new technologies have developed, care for central lines has improved; however, because care has evolved independently in local centers, care of central venous access varies significantly in this vulnerable population. The present position paper from the Intestinal Failure Special Interest Group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) reviews current evidence and provides recommendations for central line management in children with intestinal failure.
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http://dx.doi.org/10.1097/MPG.0000000000003036 | DOI Listing |
Cancers (Basel)
December 2024
Departments of Surgery, Surgical Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Background: Patients with peritoneal carcinomatosis often experience intestinal failure throughout the course of their disease, and total parenteral nutrition (TPN) can be used as a temporary solution or as a bridge to definitive cytoreductive surgery. Guidelines for TPN are well established for inpatients and in 2014, guidelines were established for the initiation of TPN for outpatients in a home setting. However, the safety and efficacy of home start TPN in advanced oncology patients remain unknown.
View Article and Find Full Text PDFBiomol Biomed
December 2024
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Severe acute pancreatitis (SAP) is one of the leading causes of hospital admissions for gastrointestinal diseases, with a rising incidence worldwide. Intestinal microbiota dysbiosis caused by SAP exacerbates systemic inflammatory response syndrome and organ dysfunction. Fecal microbiota transplantation (FMT) has emerged as a promising therapeutic option for gastrointestinal diseases.
View Article and Find Full Text PDFJ Med Case Rep
January 2025
Department of Surgery, University Hospital "Tsaritsa Joanna - ISUL", Medical University, Str. "Byalo More" No 8, Sofia, Bulgaria.
Background: McKittrick-Wheelock syndrome is an uncommon and severe disorder caused by large hypersecretory tumors located in the distal colorectal area. Excessive secretion from adenomas is an unusual clinical manifestation that leads to severe electrolyte and fluid depletion, subsequently resulting in kidney injury. Successful treatment relies on quick and cooperative decision-making for timely intervention.
View Article and Find Full Text PDFJ Pediatr Gastroenterol Nutr
January 2025
Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Objective: Intestinal transplantation (ITx) has become an accepted option for children with serious complications from intestinal failure and parenteral nutrition (PN) dependence. We aimed to assess long-term growth and nutritional outcomes in these patients. We also assessed factors influencing nutritional status and ability to wean off tube feedings (TFs) after ITx.
View Article and Find Full Text PDFJPEN J Parenter Enteral Nutr
January 2025
Department of Gastroenterology and Hepatology-Dietetics, Radboud university medical center, Nijmegen, The Netherlands.
Background: In patients with chronic intestinal failure, the content and type of parenteral nutrition are individually determined based on various factors, including body composition. In clinical practice, bioelectrical impedance analysis is used to assess body composition using standardized protocols. However, these protocols lack specific recommendations for patients receiving parenteral nutrition.
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