scholarly journals British Intestinal Failure Alliance (BIFA) guidance - haematological and biochemical monitoring of adult patients receiving home parenteral nutrition

2021 ◽  
pp. flgastro-2020-101758
Author(s):  
Gavin William Mercer-Smith ◽  
Colette Kirk ◽  
Lisa Gemmell ◽  
Christopher Mountford ◽  
Jeremy Nightingale ◽  
...  

Home parenteral nutrition (HPN) is necessary for patients with prolonged intestinal failure which can be secondary to a variety of pathophysiological mechanisms or surgical resection. HPN is needed to supply micronutrients, macronutrients and water to reduce morbidity and mortality and to maximise the patient’s quality of life.HPN requires close monitoring by a dedicated multidisciplinary team and is vital to minimise complications; both catheter related and metabolic. A regular comprehensive review is required including history, examination including anthropometry and blood testing. The focus of this review is on the monitoring of haematological and biochemical parameters.There is a paucity of evidence-based literature on the biochemical monitoring of HPN and existing guidance is sourced mostly on expert opinion and lower grade studies. Sources offering guidance on the frequency of biochemical monitoring for the stable adult HPN patient are the British Association for Parenteral and Enteral Nutrition, the European Society for Parenteral and Enteral Nutrition, the National Institute for Health and Care Excellence and the Australasian Society of Parenteral and Enteral Nutrition (AuSPEN).The aim of this work is to review and collate this existing guidance into one clear and concise review. It is recommended that biochemical parameters are checked at baseline, thereafter more frequently if concerns arise and less frequently when the patient’s condition is stable, as assessed by the multidisciplinary team with expertise in HPN.

2019 ◽  
Vol 35 (4) ◽  
pp. 567-576
Author(s):  
Emma J Osland ◽  
Kathleen H McGrath ◽  
Azmat Ali ◽  
Sharon Carey ◽  
Suzie Daniells ◽  
...  

2020 ◽  
pp. bmjspcare-2020-002562
Author(s):  
Vandana M Sagar ◽  
Tahir Shah ◽  
Hardip Malhi ◽  
Sharmalie Parkinson ◽  
Shishir Shetty ◽  
...  

BackgroundNeuroendocrine tumours (NETs) are neoplastic yet behave differently to typical cancers. Despite often being slow growing, they can lead to significant gastrointestinal complications including intestinal failure (IF). The use of home parenteral nutrition (HPN) in neoplastic conditions is rising, primarily for palliation and bridging through treatments for cancer, but remains a challenging decision with a paucity of high-grade evidence-based guidance.MethodsA retrospective analysis of patients with NET on HPN was performed. Data collected included the cause of IF, complications encountered with HPN and changes in nutritional assessments.ResultsEight patients were identified, all with metastatic NET. Median weight improved following HPN commencement and line sepsis was the sole complication. All patients had stabilisation and optimisation of nutritional and hydration status.ConclusionsHPN is commenced to improve or maintain patients’ nutritional status during often lifelong treatment. The principle aim in providing HPN was to improve survival and quality of life. While NETs are cancers, our case series demonstrates the potential of HPN to actively support longer term survival in the subgroup of patients who develop IF.


2005 ◽  
Vol 94 (5) ◽  
pp. 633-638 ◽  
Author(s):  
Janet P. Baxter ◽  
Peter M. Fayers ◽  
Alastair W. McKinlay

Home parenteral nutrition is an established method of supporting patients with intestinal failure, but this treatment may be life long and imposes severe restrictions on daily life. Impact on quality of life is an important outcome when considering the management of home parenteral nutrition patients. This paper reviews studies in which the quality of life of patients receiving home parenteral nutrition has been assessed. A systematic search of electronic databases and relevant publications was undertaken to identify generic or treatment-specific questionnaires used with home parenteral nutrition patients. Many of the thirty-four reports discovered were small studies. Nineteen used non-specific generic instruments, eight used non-validated questionnaires, four used a combination of both, and three did not use any formal tool. Few systematic patterns emerged. There are few available data on the quality of life of home parenteral nutrition patients, and there is a need for standardised, scientifically validated, treatment-specific instruments to measure quality of life in this population.


2012 ◽  
Vol 142 (5) ◽  
pp. S-613-S-614 ◽  
Author(s):  
Christopher F. Brandt ◽  
Louise Bangsgaard ◽  
Tine Jess ◽  
Michael Staun ◽  
Lone Tjellesen ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document