Avoiding the use of long‐term parenteral support in patients without intestinal failure: A position paper from the European Society of Clinical Nutrition & Metabolism, the European Society of Neurogastroenterology and Motility and the Rome Foundation for Disorders of Gut–Brain Interaction

肠外营养 医学 肠功能衰竭 临床营养学 重症监护医学 肠内给药 营养不良 立场文件 儿科 内科学 病理
作者
Simon Lal,Peter Paine,Jan Tack,Qasim Aziz,Rocco Barazzoni,Cristina Cuerda,Palle B. Jeppesen,F. Joly,Georg Lamprecht,Manpreet S. Mundi,S. Schneider,K. Szczepanek,A. Van Gossum,G. Wanten,Tim Vanuytsel,Loris Pironi
出处
期刊:Neurogastroenterology and Motility [Wiley]
卷期号:36 (9) 被引量:1
标识
DOI:10.1111/nmo.14853
摘要

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. As a result, the European Society of Clinical Nutrition and Metabolism (ESPEN), the European Society of Neuro-gastroenterology and Motility (ESNM) and the Rome Foundation for Disorders of Gut Brain Interaction felt that a position statement is required to clarify - and hopefully reduce the potential for harm associated with - the use of long-term parenteral support in patients without IF. Consensus opinion is that HPN should not be prescribed for patients without IF, where the oral and/or enteral route can be utilised. On the rare occasions that PN commencement is required to treat life-threatening malnutrition in conditions such as those listed above, it should only be prescribed for a time-limited period to achieve nutritional safety, while the wider multi-disciplinary team focus on more appropriate biopsychosocial holistic and rehabilitative approaches to manage the patient's primary underlying condition.
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