Loris Pironi1, Olivier Corcos2, Alastair Forbes3, Mette Holst4, Francisca Joly5, Cora Jonkers6, Stanislaw Klek7, Simon Lal8, Annika Reintam Blaser9, Katie E Rollins10, Anna S Sasdelli11, Jon Shaffer8, Andre Van Gossum12, Geert Wanten13, Chiara Zanfi14, Dileep N Lobo10. 1. Center for Chronic Intestinal Failure, Department of Digestive System, St. Orsola Hospital, University of Bologna, Italy. Electronic address: loris.pironi@unibo.it. 2. Intestinal Stroke Center (SURVI)/ Gastroenterology, IBD and Nutrition Support Department, Beaujon Hospital, and Laboratory for Vascular Translational Science UMR 1148, University Paris VII, France. 3. Norwich Medical School, University of East Anglia, Bob Champion Building, Norwich Research Park, Norwich, NR4 7UQ, UK. 4. Center for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Denmark. 5. Gastroenterology, IBD and Nutrition Support Department, Beaujon Hospital, and Gastrointestinal and Metabolic Dysfunctions in Nutritional Pathologies UMR 1149, University Paris VII, France. 6. Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands. 7. Stanley Dudrick's Memorial Hospital, General Surgery Unit with Intestinal Failure Center, Skawina, Poland. 8. Intestinal Failure Unit, Salford Royal & Manchester University, Manchester, UK. 9. Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia; Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland. 10. Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals and University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK. 11. Center for Chronic Intestinal Failure, Department of Digestive System, St. Orsola Hospital, University of Bologna, Italy. 12. Clinic of Intestinal Diseases and Nutritional Support, Hopital Erasme, Free University of Brussels, Brussels, Belgium. 13. Intestinal Failure Unit, Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands. 14. Department of Organ Failure and Transplantation, Sant'Orsola Hospital, University of Bologna, Italy.
Abstract
BACKGROUND & AIMS: Intestinal failure (IF) is defined as "the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth". Functionally, it may be classified as type I acute intestinal failure (AIF), type II prolonged AIF and type III chronic intestinal failure (CIF) The ESPEN Workshop on IF was held in Bologna, Italy, on 15-16 October 2017 and the aims of this document were to highlight the current state of the art and future directions for research in IF. METHODS: This paper represents the opinion of experts in the field, based on current evidence. It is not a formal review, but encompasses the current evidence, with emphasis on epidemiology, classification, diagnosis and management. RESULTS: IF is the rarest form of organ failure and can result from a variety of conditions that affect gastrointestinal anatomy and function adversely. Assessment, diagnosis, and short and long-term management involves a multidisciplinary team with diverse expertise in the field that aims to reduce complications, increase life expectancy and improve quality of life in patients. CONCLUSIONS: Both AIF and CIF are relatively rare conditions and most of the published work presents evidence from small, single-centre studies. Much remains to be investigated to improve the diagnosis and management of IF and future studies should rely on multidisciplinary, multicentre and multinational collaborations that gather data from large cohorts of patients. Emphasis should also be placed on partnership with patients, carers and government agencies in order to improve the quality of research that focuses on patient-centred outcomes that will help to improve both outcomes and quality of life in patients with this devastating condition.
BACKGROUND & AIMS:Intestinal failure (IF) is defined as "the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth". Functionally, it may be classified as type I acute intestinal failure (AIF), type II prolonged AIF and type III chronic intestinal failure (CIF) The ESPEN Workshop on IF was held in Bologna, Italy, on 15-16 October 2017 and the aims of this document were to highlight the current state of the art and future directions for research in IF. METHODS: This paper represents the opinion of experts in the field, based on current evidence. It is not a formal review, but encompasses the current evidence, with emphasis on epidemiology, classification, diagnosis and management. RESULTS: IF is the rarest form of organ failure and can result from a variety of conditions that affect gastrointestinal anatomy and function adversely. Assessment, diagnosis, and short and long-term management involves a multidisciplinary team with diverse expertise in the field that aims to reduce complications, increase life expectancy and improve quality of life in patients. CONCLUSIONS: Both AIF and CIF are relatively rare conditions and most of the published work presents evidence from small, single-centre studies. Much remains to be investigated to improve the diagnosis and management of IF and future studies should rely on multidisciplinary, multicentre and multinational collaborations that gather data from large cohorts of patients. Emphasis should also be placed on partnership with patients, carers and government agencies in order to improve the quality of research that focuses on patient-centred outcomes that will help to improve both outcomes and quality of life in patients with this devastating condition.
Authors: G Pellino; D S Keller; G M Sampietro; V Annese; M Carvello; V Celentano; C Coco; F Colombo; N Cracco; F Di Candido; M Franceschi; S Laureti; G Mattioli; L Pio; G Sciaudone; G Sica; V Villanacci; R Zinicola; S Leone; S Danese; A Spinelli; G Delaini; F Selvaggi Journal: Tech Coloproctol Date: 2020-01-25 Impact factor: 3.781
Authors: Ulrich-Frank Pape; Kishore R Iyer; Palle B Jeppesen; Marek Kunecki; Loris Pironi; Stéphane M Schneider; Douglas L Seidner; Hak-Myung Lee; John Caminis Journal: Therap Adv Gastroenterol Date: 2020-04-20 Impact factor: 4.409