Article, 2024
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
Neurogastroenterology & Motility,
ISSN
1350-1925,
1365-2982,
Page e14853,
10.1111/nmo.14853
Contributors
Lal, Simon
0000-0002-6245-8864
(Corresponding author)
[1]
Paine, Peter A
0000-0003-4131-9651
[1]
Tack, Jan Ff
0000-0002-3206-6704
[2]
[3]
Aziz, Qasim
0000-0002-2718-2065
[4]
Barazzoni, Rocco
[5]
Cuerda, Cristina
[6]
[7]
Jeppesen, Paller Bekker
0000-0001-9680-6938
[8]
Joly, F.
[9]
Lamprecht, Georg
0000-0003-0997-3135
[10]
Mundi, Manpreet S
0000-0001-7902-3544
[11]
Schneider, Stéphane Michel
0000-0001-6256-8169
[12]
Szczepanek, Kinga
[13]
Van Gossum, Andre M
[14]
Wanten, G.
[15]
Vanuytsel, Tim
0000-0001-8728-0903
[3]
Pironi, Loris
0000-0002-1773-8330
[16]
[17]
Affiliations
- [1]
University of Manchester
[NORA names:
United Kingdom; Europe, Non-EU; OECD];
- [2]
Rome Foundation
[NORA names:
United States; America, North; OECD];
- [3]
KU Leuven
[NORA names:
Belgium; Europe, EU; OECD];
- [4]
Queen Mary University of London
[NORA names:
United Kingdom; Europe, Non-EU; OECD];
- [5]
University of Trieste
[NORA names:
Italy; Europe, EU; OECD];
(... more)
- [6]
Complutense University of Madrid
[NORA names:
Spain; Europe, EU; OECD];
- [7]
Hospital General Universitario Gregorio Marañón
[NORA names:
Spain; Europe, EU; OECD];
- [8]
Rigshospitalet
[NORA names:
Capital Region of Denmark;
Hospital; Denmark; Europe, EU; Nordic; OECD];
- [9]
Inserm
[NORA names:
France; Europe, EU; OECD];
- [10]
Universitätsmedizin Rostock
[NORA names:
Germany; Europe, EU; OECD];
- [11]
Mayo Clinic
[NORA names:
United States; America, North; OECD];
- [12]
Centre Hospitalier Universitaire de Nice
[NORA names:
France; Europe, EU; OECD];
- [13]
General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland
[NORA names:
Miscellaneous; Poland; Europe, EU; OECD];
- [14]
Medico‐Surgical Department of Gastroenterology, Hôpital Erasme, Free University of Brussels, Brussels, Belgium
[NORA names:
Belgium; Europe, EU; OECD];
- [15]
Radboud University Nijmegen Medical Centre
[NORA names:
Netherlands; Europe, EU; OECD];
- [16]
Centre for Chronic Intestinal Failure, IRCCS AOUBO, Bologna, Italy
[NORA names:
Italy; Europe, EU; OECD];
- [17]
University of Bologna
[NORA names:
Italy; Europe, EU; OECD]
(less)
Abstract
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.
Keywords
ESNM,
ESPEN,
European,
European Society,
European Society of Clinical Nutrition and Metabolism,
European Society of Neurogastroenterology,
Neurogastroenterology,
PN commencement,
Rome,
approach,
benefits,
benign conditions,
bowel dysfunction,
brain interactions,
commencement,
conditions,
consensus,
consensus opinion,
disorders,
disorders of gut-brain interaction,
dysfunction,
eating disorders,
enteral route,
failure,
focus,
gut-brain interaction,
home parenteral nutrition,
impact,
interaction,
intestinal failure,
life-threatening malnutrition,
long-term home parenteral nutrition,
long-term parenteral support,
malnutrition,
metabolism,
morbidity,
mortality,
motility,
neuromuscular disorders,
nutrition,
nutritional safety,
nutritional support,
occasions,
opinion,
opioid,
opioid bowel dysfunction,
paper,
parenteral nutrition,
parenteral support,
patients,
period,
position,
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potential,
primary underlying condition,
rare occasions,
rehabilitation approaches,
results,
risk,
route,
safety,
significant impact,
statements,
support,
team focus,
underlying condition
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