Intestinal failure, malnutrition & malabsorption

Question 1

How long is acute intestinal failure?

Question 2

Describe Type 1 intestinal failure

Answer 2

Self limiting short term post-op or paralytic ileus

Question 3

Where should type 1 intestinal failure be cared for?

Answer 3

Wards (HTU. ITU)

Question 4

Describe type 2 intestinal failure.

Answer 4

Prolonged, associated with sepsis and metabolic complications. Often related to abdominal surgery with complications.

Question 5

Where should type 2 intestinal failure be cared for?

Answer 5

Wards (HTU, ITU)

Question 6

Describe type 3 intestinal failure.

Answer 6

Long term but stable - home parenternal nutrition often indicated

Question 7

What is the treatment of type 1 intestinal failure?

Answer 7

Fluids (electrolytes)
Parenteral nutrition if unable to tolerate food/fluids
PPI (acid suppression)
Alpha hydroxycholedalciferol to preserve Mg

Question 8

How is parental nutrition administered?

Answer 8

PICC (ultrasound guided)

Question 9

Complications of parenternal nutrition?

Answer 9

Pneumothorax 
Arterial puncture 
Misplacement 
Sepsis 
SVC thrombosis 
Lone leakage/fracture 
Metabolic disturbance 
Liver disease

Question 10

What patients is type 2 intestinal failure associated with?

Answer 10

Septic patients

Question 11

How do you assess type 2 intestinal failure?

Answer 11

S - sepsis
N - nutrition (fluid & electrolytes)
A - assessment radio logically to find sepsis or fistulae (CT)
P - plan surgical management

Question 12

What patients is home parenteral used in?

Answer 12

Chronic intestinal failure

Question 13

What is short bowel syndrome?

Answer 13

When the small bowel is of insufficient length to meet nutritional needs without artificial support

Question 14

What is intestinal failure?

Answer 14

The inability to maintain adequate nutrition or fluid status via the intestines