9 results match your criteria: "National Intestinal Failure Reference Centre[Affiliation]"

Development and validation of the Crohn's disease-intestinal failure-wean (CDIF-Wean) Score to predict outcomes of intestinal rehabilitation.

Clin Nutr

December 2024

Department of Intestinal Failure and Liver Diseases, Rigshospitalet & Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Electronic address:

Background & Aims: Enteral autonomy, a key outcome of intestinal rehabilitation in patients with intestinal failure (IF), is challenging to predict due to disease complexity and heterogeneity. The aim of this cohort study is to develop and validate a multivariate model to predict enteral autonomy in patients with IF caused by Crohn's disease (CDIF), and to derive an outcome-based severity classification for CDIF.

Methods: The CDIF-Wean Score was constructed and internally validated in a cohort of 182 patients with CDIF from a tertiary IF unit.

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Chyme reinfusion therapy in adults with severe acute intestinal failure: A descriptive cohort study.

JPEN J Parenter Enteral Nutr

January 2025

National Intestinal Failure Reference Centre, Northern Care Alliance NHS Foundation Trust, University of Manchester, Salford, UK.

Background: Chyme reinfusion therapy treats patients with high-output fistulas or stomas by returning chyme to the distal gut. The role of this treatment in severe acute intestinal failure is currently unclear. The primary outcome of this study was a successful establishment of chyme reinfusion therapy, defined by the ability to replace parenteral nutrition for nutrition support.

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Background & Aims: Home Parenteral Nutrition (HPN) prescriptions should be tailored to a patient's nutritional requirements and comprise of individually compounded regimens (IC-HPN) or standard licensed multi-chamber bags (MCB). There is a paucity of research exploring factors associated with admixture type. This study aimed to evaluate the nutrient composition of adult IC-HPN prescriptions and variance in nutrient dosing, make comparisons with the range of MCB available and dosing recommendations stated in international guidelines.

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Background: Outcomes related to chronic intestinal failure (CIF) vary significantly within and between countries. While there are extensive European Society of Clinical Nutrition and Metabolism (ESPEN) guidelines on the delivery of optimal care in CIF, there are no international consensus recommendations on the structure or resources required, nor on the process and appropriate outcome measures for delivering such quality care in CIF.

Aim: The aim of this position paper is therefore to devise ESPEN-endorsed, internationally agreed quality of care standards, covering the resources, systems and standards that centres should aim for in order to deliver optimal CIF care.

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Home parenteral nutrition (HPN) is a complex therapy, which requires dedicated facilities and expertise. However, the management and provision of HPN differs significantly between countries and between HPN centers within countries. These differences lead to heterogeneity in the quality of care received by patients, with variable impact on the appropriateness, safety, and effectiveness of HPN, and resultant variability in the quality of life that a patient may expect.

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The role of long-term parenteral support in patients with underlying benign conditions who do not have intestinal failure (IF) is contentious, not least since there are clear benefits in utilising the oral or enteral route for nutritional support. Furthermore, the risks of long-term home parenteral nutrition (HPN) are significant, with significant impacts on morbidity and mortality. There has, however, been a recent upsurge of the use of HPN in patients with conditions such as gastro-intestinal neuromuscular disorders, opioid bowel dysfunction, disorders of gut-brain interaction and possibly eating disorders, who do not have IF.

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Article Synopsis
  • - The study assessed chronic kidney disease (CKD) occurrence in patients on home parenteral nutrition (HPN), revealing that over 40% had renal impairment upon starting HPN, with 15.4% meeting CKD criteria.
  • - Data was collected from 357 patients over a median follow-up of 4.7 years, showing a significant decrease in estimated glomerular filtration rate (eGFR) during the first year, followed by stabilization.
  • - Despite initial declines in renal function, the long-term outlook appears positive, with the rate of eGFR decline post-HPN initiation comparable to that of the general population, reassuring for patient monitoring and outcomes.
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The role of long-term parenteral support in patients with underlying benign conditions who do not have intestinal failure (IF) is contentious, not least since there are clear benefits in utilising the oral or enteral route for nutritional support. Furthermore, the risks of long-term home parenteral nutrition (HPN) are significant, with significant impacts on morbidity and mortality. There has, however, been a recent upsurge of the use of HPN in patients with conditions such as gastro-intestinal neuromuscular disorders, opioid bowel dysfunction, disorders of gut-brain interaction and possibly eating disorders, who do not have IF.

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