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Repeated Metabolic Balance Studies in Patients With Short Bowel Syndrome

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@article{411e53bc8c7046218ade98453b6d84d8,
title = "Repeated Metabolic Balance Studies in Patients With Short Bowel Syndrome",
abstract = "BACKGROUND: Weaning from parenteral support is considered indirect evidence of intestinal adaptation in patients with short bowel syndrome (SBS), but direct evidence is lacking. The objective of this study was to examine if intestinal adaptation could be demonstrated as increase in intestinal absorption of energy and wet weight over time measured by repeated metabolic balance studies (MBSs) and to examine whether adaptation was determined by the anatomy of the remnant bowel.METHODS: We retrospectively analyzed data from 48 repeated MBSs performed in 13 adult patients with SBS. Results were presented graphically and interpreted. The interpatient and intrapatient heterogeneity was compared based on anatomy of the remnant bowel.RESULTS: The number of repeated MBSs ranged from 2 to 7, and time between last intestinal resection and MBS from 5 months to 18.1 years. In 6 patients, the first MBS was performed within 2 years after last resection, but only 1 patient had repeated MBSs within this period. Nine patients had an end jejunoileostomy, and 4 patients had a jejuno-colonic or ileo-colonic anastomosis. None of the patients had jejunoileal anastomosis with a preserved ileocecal valve. Interpatient and intrapatient heterogeneity of wet weight and energy absorption was larger in patients without colon in continuity. The wet weight and energy absorption data showed no tendency toward intestinal adaptation in any anatomical group.CONCLUSION: We observed no signs of late-phase intestinal adaptation in this selected group of patients with SBS. Future prospective MBSs are needed to understand the time course and magnitude of intestinal adaptation.",
keywords = "intestinal adaptation, intestinal failure, intestinal insufficiency, metabolic balance study, parenteral nutrition, parenteral support, short bowel syndrome",
author = "Haifeng Sun and Johanna Eliasson and Fuglsang, {Kristian A} and Mark Hvistendahl and Naimi, {Rahim M} and Jeppesen, {Palle B}",
note = "{\circledC} 2019 American Society for Parenteral and Enteral Nutrition.",
year = "2020",
month = "5",
doi = "10.1002/jpen.1704",
language = "English",
volume = "44",
pages = "677--687",
journal = "Journal of Parenteral and Enteral Nutrition",
issn = "0148-6071",
publisher = "Sage Science Press (US)",
number = "4",

}

RIS

TY - JOUR

T1 - Repeated Metabolic Balance Studies in Patients With Short Bowel Syndrome

AU - Sun, Haifeng

AU - Eliasson, Johanna

AU - Fuglsang, Kristian A

AU - Hvistendahl, Mark

AU - Naimi, Rahim M

AU - Jeppesen, Palle B

N1 - © 2019 American Society for Parenteral and Enteral Nutrition.

PY - 2020/5

Y1 - 2020/5

N2 - BACKGROUND: Weaning from parenteral support is considered indirect evidence of intestinal adaptation in patients with short bowel syndrome (SBS), but direct evidence is lacking. The objective of this study was to examine if intestinal adaptation could be demonstrated as increase in intestinal absorption of energy and wet weight over time measured by repeated metabolic balance studies (MBSs) and to examine whether adaptation was determined by the anatomy of the remnant bowel.METHODS: We retrospectively analyzed data from 48 repeated MBSs performed in 13 adult patients with SBS. Results were presented graphically and interpreted. The interpatient and intrapatient heterogeneity was compared based on anatomy of the remnant bowel.RESULTS: The number of repeated MBSs ranged from 2 to 7, and time between last intestinal resection and MBS from 5 months to 18.1 years. In 6 patients, the first MBS was performed within 2 years after last resection, but only 1 patient had repeated MBSs within this period. Nine patients had an end jejunoileostomy, and 4 patients had a jejuno-colonic or ileo-colonic anastomosis. None of the patients had jejunoileal anastomosis with a preserved ileocecal valve. Interpatient and intrapatient heterogeneity of wet weight and energy absorption was larger in patients without colon in continuity. The wet weight and energy absorption data showed no tendency toward intestinal adaptation in any anatomical group.CONCLUSION: We observed no signs of late-phase intestinal adaptation in this selected group of patients with SBS. Future prospective MBSs are needed to understand the time course and magnitude of intestinal adaptation.

AB - BACKGROUND: Weaning from parenteral support is considered indirect evidence of intestinal adaptation in patients with short bowel syndrome (SBS), but direct evidence is lacking. The objective of this study was to examine if intestinal adaptation could be demonstrated as increase in intestinal absorption of energy and wet weight over time measured by repeated metabolic balance studies (MBSs) and to examine whether adaptation was determined by the anatomy of the remnant bowel.METHODS: We retrospectively analyzed data from 48 repeated MBSs performed in 13 adult patients with SBS. Results were presented graphically and interpreted. The interpatient and intrapatient heterogeneity was compared based on anatomy of the remnant bowel.RESULTS: The number of repeated MBSs ranged from 2 to 7, and time between last intestinal resection and MBS from 5 months to 18.1 years. In 6 patients, the first MBS was performed within 2 years after last resection, but only 1 patient had repeated MBSs within this period. Nine patients had an end jejunoileostomy, and 4 patients had a jejuno-colonic or ileo-colonic anastomosis. None of the patients had jejunoileal anastomosis with a preserved ileocecal valve. Interpatient and intrapatient heterogeneity of wet weight and energy absorption was larger in patients without colon in continuity. The wet weight and energy absorption data showed no tendency toward intestinal adaptation in any anatomical group.CONCLUSION: We observed no signs of late-phase intestinal adaptation in this selected group of patients with SBS. Future prospective MBSs are needed to understand the time course and magnitude of intestinal adaptation.

KW - intestinal adaptation

KW - intestinal failure

KW - intestinal insufficiency

KW - metabolic balance study

KW - parenteral nutrition

KW - parenteral support

KW - short bowel syndrome

U2 - 10.1002/jpen.1704

DO - 10.1002/jpen.1704

M3 - Journal article

VL - 44

SP - 677

EP - 687

JO - Journal of Parenteral and Enteral Nutrition

JF - Journal of Parenteral and Enteral Nutrition

SN - 0148-6071

IS - 4

ER -

ID: 59434441