Division of Gastroenterology and Endocrinology, Department of Internal Medicine, University Medical Center Rostock, Ernst-Heydemann-Str. 6, 18057 Rostock, Germany.
Institute for Biostatistics and Informatics in Medicine and Ageing Research, University Medical Center Rostock, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany.
Nutrients. 2020 Nov 8;12(11):3426. doi: 10.3390/nu12113426.
Intestinal failure (IF) requires parenteral support (PS) substituting energy, water, and electrolytes to compensate intestinal losses and replenish deficits. Convalescence, adaptation, and reconstructive surgery facilitate PS reduction. We analyzed the effect of changes of PS on body mass index (BMI) in early adult IF. Energy, volume, and sodium content of PS and BMI were collected at the initial contact (FIRST), the time of maximal PS and BMI (MAX) and the last contact (LAST). Patients were categorized based on functional anatomy: small bowel enterostomy-group 1, jejuno-colic anastomosis-group 2. Analysis of variance was used to test the relative impact of changes in energy, volume, or sodium. Total of 50 patients were followed for 596 days. Although energy, volume, and sodium support were already high at FIRST, we increased PS to MAX, which was accompanied by a significant BMI increase. Thereafter PS could be reduced significantly, leading to a small BMI decrease in group 1, but not in group 2. Increased sodium support had a stronger impact on BMI than energy or volume. Total of 13 patients were weaned. Dynamic PS adjustments are required in the early phase of adult IF. Vigorous sodium support acts as an independent factor.
肠衰竭（IF）需要肠外支持（PS）来替代能量、水和电解质，以补偿肠道损失并补充不足。康复、适应和重建手术有助于减少 PS。我们分析了 PS 变化对早期成年 IF 患者体重指数（BMI）的影响。在初次接触（FIRST）、PS 和 BMI 最大时（MAX）和最后一次接触（LAST）时收集 PS 的能量、容量和钠含量以及 BMI。根据功能解剖将患者分为：小肠造口术组 1，空肠结肠吻合术组 2。方差分析用于测试能量、体积或钠变化的相对影响。共 50 例患者随访 596 天。尽管 FIRST 时能量、容量和钠支持已经很高，但我们将 PS 增加到 MAX，这伴随着 BMI 的显著增加。此后，PS 可以显著减少，导致组 1 的 BMI 略有下降，但组 2 没有。增加钠支持对 BMI 的影响大于能量或体积。共有 13 例患者被成功脱机。成人 IF 的早期阶段需要进行动态 PS 调整。积极的钠支持是一个独立的因素。
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