Intestinal Failure Flashcards
Intestinal failure
Where the gut is no longer able to supply the hydration and nutritional needs of the body
Type 1 intestinal failure:
- How long?
- Management
- Causes
- Short term - days/weeks
- Replace fluids, correct electrolytes, acid suppression (PPIs), octreotide, alpha hydroxycholecalciferol to preserve Mg
- GI problems, surgical ileus, critical illness
GI problems causing intestinal failure
Vomiting, dysphagia, diarrhoea, pancreatitis, GI obstruction, oncology
Type 2 intestinal failure:
- How long?
- Causes
- Management
- Medium term - weeks/months
- Post-surgery awaiting reconstruction
- Significant and prolonged PN support (>28 days) and admission to ICU/HDU
Type 3 intestinal failure
- How long?
- Causes
- Management
- Chronic - long term
- Short bowel syndrome, Crohn’s, radiation, malabsorption, inoperable obstruction
- Long term PN support, wards to home, glucagon-like-peptide-2 treatment for short bowel syndrome
What length of bowel is considered a short bowel?
<200cm
What is short bowel syndrome?
When there is insufficient length of small bowel to meet nutritional needs without artificial nutritional support
Most common indication for home parenteral nutrition
<50cm of small bowel
Types of short bowel
Jejunostomy, ileostomy, jejuno-colic anastomosis, ileo-colic anastomosis
How can parenteral nutrition be given?
Via peripheral venous access or central venous access
Complications of central venous access
Pneumothorax, arterial puncture, misplacement
Complications of parenteral nutrition
Sepsis, SVS thrombosis, line fracture, line leakage, line migration, metabolic bone disease, nutrient toxicity/insufficiency, liver disturbance, metabolic disturbance psycho-social, inappropriate usage
Main indicators for small bowel transplantation
Loss of venous access/liver disease
