Clinical Recommendations of the Northwest Society for Enteral and Parenteral Nutrition, Interregional Association for Emergency Surgery, Russian Gastroenterological Association, Union of Rehabilitation Therapists of Russia and Russian Transplantation Society on Diagnosis and Treatment of Short Bowel Syndrome-Associated Intestinal Failure in Adults

Российский журнал гастроэнтерологии, гепатологии, колопроктологии

V. T. Ivashkin¹  A. L. Potapov²  A. S. Trukhmanov³  V. M. Luft⁴  A. V. Lapitsky⁵  G. E. Ivanova⁶  M. S. Novruzbekov⁶  Yu. V. Averyanova⁷  A. E. Demko⁸  I. N. Leiderman⁸  E. M. Batyrshin⁸  I. V. Maev⁸  A. V. Sytov⁹  L. N. Kostyuchenko⁹  I. G. Nikitin^1,10  Е. A. Poluektova^1,10 

[1] Research Centre for Rehabilitation Medicine, Federal Brain and Neurotechnology Centre, Federal Medical and Biological Agency of Russia;Sklifosovsky Clinical and Research Institute for Emergency Medicine;A. Tsyb Medical Radiological Research Centre — Branch of the National Medical Research Radiological Centre;Almazov National Medical Research Centre;Loginov Moscow Clinical Scientific Centre;Pirogov Russian National Research Medical University;Russian Children's Clinical Hospital, Pirogov Russian National Research Medical University;Saint-Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine;Sechenov First Moscow State Medical University (Sechenov University);Yevdokimov Moscow State University of Medicine and Dentistry;

关键词: short bowel;    intestinal failure;    protein-energy malnutrition;    nutritional status;    nutritional support;    metabolic therapy;    parenteral nutrition;    enteral nutrition;   

DOI  :  10.22416/1382-4376-2022-32-1-60-103

来源: DOAJ

【 摘 要 】

Aim. Current clinical recommendations address the epidemiology, causes, clinical manifestations and pathogenesis of possible immediate and long-term complications, as well as the problematic issues related to treatment and rehabilitation of adult short bowel syndrome patients.Key points. Short bowel syndrome (SBS) is a symptom complex of impaired digestion caused by the reduction of small intestine absorptive surface and manifested by intestinal failure (IF) of various severity (maldigestion and malabsorption) developing into malnutrition and systemic somatogenic disorders. The vital strategic aspects of its treatment are the personalisation of liquid, macro- and micronutrients consumption as well as avoidance of intestinal failure- and parenteral nutrition-associated complications. Various nutritional support regimes and the indications for infusion therapy and maintenance parenteral nutrition are considered in this patient category, also in outpatient settings. To mitigate the dependence on intravenous fluid- and nutrient administration and attain enteral autonomy in SBS-IF patients, the use of recombinant glucagon-like peptide-2 (GLP-2) is justified as exerting a pronounced trophic effect on the epithelial regenerative potential as well as structural and functional adaptation of intestinal mucosa. The SBS-IF patients prescribed with home parenteral nutrition and/or their caregivers should be trained in a special programme that covers the catheter care, preparation of infusion solutions and nutrient mixture container, infusion pump operation as well as the prevention, recognition and management of complications. The main referral indications for small bowel transplantation (SBT) are: fast-progressing cholestatic liver disease-complicated irreversible intestinal failure; thrombosis of two or more central venous conduits used for parenteral nutrition; recurrent catheter-associated bloodstream infection.Conclusion. Current recommendations on diagnosis and treatment as well as the developed criteria of medical aid quality assessment are applicable at different levels of healthcare.

【 授权许可】

Unknown