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Artikel ; Online: Pediatric Intestinal Failure Associated Eating Disorder: An Overview of the Importance of Oral Feeding in a Population at Risk for Feeding Difficulties.

Boctor, Dana Liza / Fenton, Tanis R / Goulet, Olivier / Lambe, Cecile

Gastroenterology clinics of North America

2024 Band 53, Heft 2, Seite(n) 309–327

Abstract: Achieving feeding skills and food acceptance is a multi-layered process. In pediatric intestinal failure (PIF), oral feeding is important for feeding skills development, physiologic adaptation, quality of life and the prevention of eating disorders. In ... ...

Abstract	Achieving feeding skills and food acceptance is a multi-layered process. In pediatric intestinal failure (PIF), oral feeding is important for feeding skills development, physiologic adaptation, quality of life and the prevention of eating disorders. In PIF, risk factors for feeding difficulties are common and early data suggests that feeding difficulties are prevalent. There is a unique paradigm for the feeding challenges in PIF. Conventional definitions of eating disorders have limited application in this context. A pediatric intestinal failure associated eating disorder (IFAED) definition that includes feeding/eating skills dysfunction, psychosocial dysfunction, and the influence on weaning nutrition support is proposed.
Mesh-Begriff(e)	Humans ; Child ; Feeding and Eating Disorders/complications ; Risk Factors ; Intestinal Failure/therapy ; Feeding Behavior
Sprache	Englisch
Erscheinungsdatum	2024-02-01
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Review
ZDB-ID	92114-2
ISSN	1558-1942 ; 0889-8553
ISSN (online)	1558-1942
ISSN	0889-8553
DOI	10.1016/j.gtc.2023.12.003
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Cannabinoids Improve Gastrointestinal Symptoms in a Parenteral Nutrition-Dependent Patient With Chronic Intestinal Pseudo-Obstruction.

Zemrani, Boutaina / Lambe, Cécile / Goulet, Olivier

JPEN. Journal of parenteral and enteral nutrition

2020 Band 45, Heft 2, Seite(n) 427–429

Abstract: Chronic intestinal pseudo-obstruction (CIPO) is a rare and challenging cause of pediatric intestinal failure, requiring long-term parenteral nutrition in most cases. Despite optimal management, some patients experience chronic abdominal pain and ... ...

Abstract	Chronic intestinal pseudo-obstruction (CIPO) is a rare and challenging cause of pediatric intestinal failure, requiring long-term parenteral nutrition in most cases. Despite optimal management, some patients experience chronic abdominal pain and recurrent obstructive episodes with a major impact on their quality of life. Cannabinoids have been successfully used in some conditions. However, their use in CIPO has never been reported in the literature. We report a case of successful use of medicinal cannabinoids in a patient with CIPO, resulting in a significant reduction of abdominal pain, vomiting, and subocclusive episodes and increased appetite and weight, without major adverse events. Although further observations are required to consolidate these findings, this case may be helpful for other patients suffering from the same condition.
Mesh-Begriff(e)	Cannabinoids ; Child ; Chronic Disease ; Humans ; Intestinal Pseudo-Obstruction/complications ; Intestinal Pseudo-Obstruction/therapy ; Parenteral Nutrition, Total ; Quality of Life
Chemische Substanzen	Cannabinoids
Sprache	Englisch
Erscheinungsdatum	2020-03-17
Erscheinungsland	United States
Dokumenttyp	Case Reports
ZDB-ID	800861-9
ISSN	1941-2444 ; 0148-6071
ISSN (online)	1941-2444
ISSN	0148-6071
DOI	10.1002/jpen.1821
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Intravenous lipid emulsions in pediatric patients with intestinal failure.

Goulet, Olivier / Lambe, Cécile

Current opinion in organ transplantation

2017 Band 22, Heft 2, Seite(n) 142–148

Abstract: The incidence of cholestatic liver disease (CLD) in pediatric patients suffering intestinal failure (IF) is not well established. Due to persistent portal inflammation, about 20% of these patients will progress to end-stage intestinal failure associated ... ...

Abstract	The incidence of cholestatic liver disease (CLD) in pediatric patients suffering intestinal failure (IF) is not well established. Due to persistent portal inflammation, about 20% of these patients will progress to end-stage intestinal failure associated liver disease (IFALD) leading to liver transplant or death. Purpose of review: Premature babies as well as infants with short bowel syndrome (SBS) and repeated sepsis (catheter or small intestinal bacterial overgrowth related) are at risk of developing CLD. Clinical data in SBS infants focused on intravenous lipid emulsion (ILE) as an important factor of CLD. Recent findings: Compared to the last generation of composite ILE containing fish oil (FO), soybean oil (SO) based ILE, have marked differences in term of oil source, omega-3 fatty acids (FAs) composition, vitamin E (α-tocopherols) and plant sterols contents, that may explain CLD and CLD reversal. Randomized controlled trials and meta-analysis allow the following recommendations. Summary: In pediatric patients with developing or established CLD or IFALD, potential causes should be explored and pure SO ILE should be avoided. A reduction of the ILE dosage and/or the use of the new composite FO based ILE, may be recommended along with the treatment and management of other risk factors. The 10% pure FO ILE should not be used as a sole provision of IV lipids in paediatric patients on total PN but can only serve as a short-term rescue treatment.
Sprache	Englisch
Erscheinungsdatum	2017-04
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	1390429-2
ISSN	1531-7013 ; 1087-2418
ISSN (online)	1531-7013
ISSN	1087-2418
DOI	10.1097/MOT.0000000000000396
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: The Impact of Teduglutide on Real-Life Health Care Costs in Children with Short Bowel Syndrome.

Cucinotta, Ugo / Acunzo, Miriam / Payen, Elise / Talbotec, Cécile / Chasport, Céline / Alibrandi, Angela / Lacaille, Florence / Lambe, Cécile

The Journal of pediatrics

2023 , Seite(n) 113882

Abstract: Objectives: To analyze the real-life health care costs of home parenteral nutrition (HPN) in children with short bowel syndrome with intestinal failure (SBS-IF) before and after treatment with teduglutide, and to compare those with costs of children ... ...

Abstract	Objectives: To analyze the real-life health care costs of home parenteral nutrition (HPN) in children with short bowel syndrome with intestinal failure (SBS-IF) before and after treatment with teduglutide, and to compare those with costs of children with SBS-IF not treated with teduglutide. Study design: All consecutive children with SBS-IF on HPN treated with subcutaneous teduglutide starting from 2018 through 2020 in a tertiary French referral center were retrospectively included. These patients were matched to children with SBS-IF on HPN followed during the same 3-year period who were eligible for the teduglutide but were not treated. HPN direct medical costs included: home-care visits, HPN bags, hospital admissions, and teduglutide. A comparison of costs before/after treatment, and between patients treated/not treated was performed. Results: Sixty children were included: 30 (50%) treated with teduglutide and 30 (50%) untreated. In the treated group, the median total costs of HPN significantly decreased after 1 (p<0.001) and 2 years of treatment (p<0.001) from 59.454 euros/year/patient to 43.885 euros/year/patient and 34.973 euros/year/patient, respectively. Comparing patients treated and not treated, the total HPN costs/year/patient were similar at baseline (p=0.6) but were significantly lower in the teduglutide-treated group after 1 (p=0.006) and 2 years of treatment (p<0.001). When adding the cost of teduglutide into the analysis, the total cost increased significantly in the treated group, and remained much higher even after modeling a reduction in the cost of the drug to 1/3 the present cost and PN weaning (p<0.001). Conclusions: Treatment with teduglutide is associated with a significant reduction in the annual costs of HPN but still remains expensive because of the drug itself. Finding cost saving strategies is essential.
Sprache	Englisch
Erscheinungsdatum	2023-12-20
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2023.113882
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Long-term treatment with teduglutide: a 48-week open-label single-center clinical trial in children with short bowel syndrome.

Lambe, Cécile / Talbotec, Cécile / Kapel, Nathalie / Barbot-Trystram, Laurence / Brabant, Séverine / Nader, Elie Abi / Pigneur, Bénédicte / Payen, Elise / Goulet, Olivier

The American journal of clinical nutrition

2023 Band 117, Heft 6, Seite(n) 1152–1163

Abstract: Background: Short bowel syndrome (SBS) is the main cause of intestinal failure in children.: Objectives: This single-center study evaluated the safety and efficacy of teduglutide in pediatric patients with SBS-associated intestinal failure (SBS-IF).!# ...

Abstract	Background: Short bowel syndrome (SBS) is the main cause of intestinal failure in children. Objectives: This single-center study evaluated the safety and efficacy of teduglutide in pediatric patients with SBS-associated intestinal failure (SBS-IF). Methods: Children with SBS followed at our center with ≥2 y on parenteral nutrition (PN) and with small bowel length <80 cm who had reached a plateau were consecutively included in the study. At baseline, participants underwent a clinical assessment including a 3-d stool balance analysis, which was repeated at the end of the study. Teduglutide was administered subcutaneously 0.05 mg/kg/d for 48 wk. PN dependence was expressed as the PN dependency index (PNDI), which is the ratio PN non-protein energy intake/REE. Safety endpoints included treatment-emergent adverse events and growth parameters. Results: Median age at inclusion was 9.4 y (range: 5-16). The median residual SB length was 26 cm (IQR: 12-40). At baseline, the median PNDI was 94% (IQR: 74-119), (median PN intake: 38.9 calories/kg/d, IQR: 26.1-48.6). At week 24, 24 (96%) children experienced a reduction of >20% of PN requirements with a median PNDI = 50% (IQR: 38-81), (PN intake: 23.5 calories/kg/d IQR: 14.6-26.2), P < 0.01. At week 48, 8 children (32%) were weaned completely off PN. Plasma citrulline increased from 14 μmol/L (IQR: 8-21) at baseline to 29 μmol/L (IQR: 17-54) at week 48 (P < 0.001). Weight, height, and BMI z-scores remained stable. The median total energy absorption rate increased from 59% (IQR: 46-76) at baseline to 73% (IQR: 58-81) at week 48 (P = 0.0222). Fasting and postprandial endogenous GLP-2 concentrations increased at weeks 24 and 48 compared with baseline. Mild abdominal pain at the early phase of treatment, stoma changes, and redness at the injection site were commonly reported. Conclusions: Increased intestinal absorption and PN dependency reduction were observed with teduglutide treatment in children with SBS-IF. Trial registration: ClinicalTrials.gov NCT03562130. https://clinicaltrials.gov/ct2/show/NCT03562130?term=NCT03562130&draw=2&rank=1.
Mesh-Begriff(e)	Humans ; Child ; Short Bowel Syndrome/therapy ; Intestinal Failure ; Intestine, Small ; Peptides/therapeutic use ; Gastrointestinal Agents/adverse effects
Chemische Substanzen	teduglutide (7M19191IKG) ; Peptides ; Gastrointestinal Agents
Sprache	Englisch
Erscheinungsdatum	2023-05-03
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	280048-2
ISSN	1938-3207 ; 0002-9165
ISSN (online)	1938-3207
ISSN	0002-9165
DOI	10.1016/j.ajcnut.2023.02.019
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Metabolic bone disease in children with intestinal failure is not associated with the level of parenteral nutrition dependency

Nader, Elie Abi / Lambe, Cécile / Talbotec, Cécile / Acramel, Alexandre / Pigneur, Bénédicte / Goulet, O.

Clinical nutrition. 2021 Apr., v. 40, no. 4, p. 1974-1982

2021 , Seite(n) 1974–1982

Abstract: Children on long-term home parenteral nutrition (HPN) are at increased risk of suboptimal growth and metabolic bone disease (MBD) i.e. decreased bone mineral density (BMD). The aims of this cross-sectional study were to assess growth and bone health in ... ...

Abstract	Children on long-term home parenteral nutrition (HPN) are at increased risk of suboptimal growth and metabolic bone disease (MBD) i.e. decreased bone mineral density (BMD). The aims of this cross-sectional study were to assess growth and bone health in children on long term HPN and to identify risk factors for MBD.Children above the age of 5 years, stable on HPN for more than 2 years were included. Medical files were reviewed retrospectively and included demographics, gestational age, birth weight and height, indication for PN, age at PN start, duration of PN, number of weekly PN infusions, weight-for-age and height-for-age (SD), body mass index (BMI, kg/m²) as well as blood and urine analyses at the time of Dual X-ray absorptiometry (DXA) measurements. All BMD values were adjusted to statural age which corresponds to the 50th percentile of height. Growth failure (height-for-age ≤ -2SD) and MBD (at least one BMD measurement ≤ -2SD) were analyzed according to the indication of PN, duration of PN and PN dependency index (PNDI) by comparing means and performing logistic regression analysis. PNDI is the ratio of non-protein energy intake in HPN to resting energy expenditure using Schofield equations.Forty children were assessed at 12.4 ± 4.5 years of age. Mean age at PN start was 1.1 ± 3.6 y (median 0.5). The indications for PN were short bowel syndrome (SBS, n = 21), chronic intestinal pseudo-obstruction syndrome (CIPOS, n = 10) and congenital enteropathies (CE, n = 9). The mean number of PN perfusions was 6 ± 1/week. PNDI was 110 ± 30%. The mean serum level of 25-OHD3 was suboptimal at 26.5 ± 9.1 ng/mL (66.2 ± 22.8 nmol/L). The mean concentrations of calcium, phosphorus, and parathyroid hormone (PTH) were in the normal ranges. Eight children (20%) had PTH levels above normal with low 25-OHD3 levels. The mean weight-for-age and height-for-age Z-scores SDS were 0.4 ± 0.9 and −0.5 ± 1.1 respectively. The actual height was lower than genetic target height (p < 0.001). The BMD Z-scores, adjusted to the 50th percentile of height, of the spine, the left femur and the whole body were: −1.1 ± 1.7, −1.2 ± 1.5 and −1.5 ± 1.8 SDS respectively. Children with CE had significantly lower BMD values than those with SBS and CIPOS (p = 0.01). Only two children had bone fractures after a mild trauma (5%).All children on long-term PN, are at risk of low BMD. High dependency on PN (PNDI>120%) and very long-term PN (>10 years) do not appear to increase the risk of growth failure nor MBD. PN-related bone fractures were rare. Close follow-up remains mandatory.
Schlagwörter	birth weight ; blood serum ; body mass index ; bone density ; bone fractures ; bone health ; calcium ; children ; clinical nutrition ; cross-sectional studies ; demographic statistics ; developmental orthopedic disease ; digestive system diseases ; dual-energy X-ray absorptiometry ; duration ; energy intake ; femur ; gestational age ; height ; intestines ; measurement ; parathyroid hormone ; parenteral feeding ; phosphorus ; regression analysis ; resting energy expenditure ; risk factors ; Children ; Intestinal failure ; Home parenteral nutrition ; Bone mineral density ; Growth
Sprache	Englisch
Erscheinungsverlauf	2021-04
Umfang	p. 1974-1982.
Erscheinungsort	Elsevier Ltd
Dokumenttyp	Artikel ; Online
ZDB-ID	604812-2
ISSN	1532-1983 ; 0261-5614
ISSN (online)	1532-1983
ISSN	0261-5614
DOI	10.1016/j.clnu.2020.09.014
Datenquelle	NAL Katalog (AGRICOLA)

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Artikel ; Online: Long-term treatment with teduglutide: a 48-week open-label single-center clinical trial in children with short bowel syndrome

Lambe, Cécile / Talbotec, Cécile / Kapel, Nathalie / Barbot-Trystram, Laurence / Brabant, Séverine / Nader, Elie Abi / Pigneur, Bénédicte / Payen, Elise / Goulet, O.

American Society for Nutrition The American Journal of Clinical Nutrition. 20232023 June 03, May 03, v. 117, no. 6 p.1152-1163

2023

Abstract: Short bowel syndrome (SBS) is the main cause of intestinal failure in children. This single-center study evaluated the safety and efficacy of teduglutide in pediatric patients with SBS–associated intestinal failure (SBS-IF). Children with SBS followed at ...

Abstract	Short bowel syndrome (SBS) is the main cause of intestinal failure in children. This single-center study evaluated the safety and efficacy of teduglutide in pediatric patients with SBS–associated intestinal failure (SBS-IF). Children with SBS followed at our center with ≥2 y on parenteral nutrition (PN) and with small bowel length <80 cm who had reached a plateau were consecutively included in the study. At baseline, participants underwent a clinical assessment including a 3-d stool balance analysis, which was repeated at the end of the study. Teduglutide was administered subcutaneously 0.05 mg/kg/d for 48 wk. PN dependence was expressed as the PN dependency index (PNDI), which is the ratio PN non-protein energy intake/REE. Safety endpoints included treatment-emergent adverse events and growth parameters. Median age at inclusion was 9.4 y (range: 5–16). The median residual SB length was 26 cm (IQR: 12–40). At baseline, the median PNDI was 94% (IQR: 74–119), (median PN intake: 38.9 calories/kg/d, IQR: 26.1–48.6). At week 24, 24 (96%) children experienced a reduction of >20% of PN requirements with a median PNDI = 50% (IQR: 38–81), (PN intake: 23.5 calories/kg/d IQR: 14.6–26.2), P < 0.01. At week 48, 8 children (32%) were weaned completely off PN. Plasma citrulline increased from 14 μmol/L (IQR: 8–21) at baseline to 29 μmol/L (IQR: 17–54) at week 48 (P < 0.001). Weight, height, and BMI z-scores remained stable. The median total energy absorption rate increased from 59% (IQR: 46–76) at baseline to 73% (IQR: 58–81) at week 48 (P = 0.0222). Fasting and postprandial endogenous GLP-2 concentrations increased at weeks 24 and 48 compared with baseline. Mild abdominal pain at the early phase of treatment, stoma changes, and redness at the injection site were commonly reported. Increased intestinal absorption and PN dependency reduction were observed with teduglutide treatment in children with SBS-IF. ClinicalTrials.gov NCT03562130. https://clinicaltrials.gov/ct2/show/NCT03562130?term=NCT03562130&draw=2&rank=1
Schlagwörter	absorption ; citrulline ; clinical nutrition ; clinical trials ; digestive system diseases ; energy intake ; glucagon-like peptide 2 ; injection site ; intestinal absorption ; intestines ; pain ; parenteral feeding ; pediatrics ; intestinal failure ; short bowel syndrome ; parenteral nutrition ; home parenteral nutrition ; GLP-2 analog ; teduglutide ; stool balance analysis ; parenteral nutrition dependency index ; AAs ; CVC ; EGF ; ESPEN ; ESPGHAN ; ETF ; HPN ; ICV ; IF ; LILT ; NPEI ; PN ; PNDI ; SBS ; SMOF ; SPC ; STEP
Sprache	Englisch
Erscheinungsverlauf	2023-0503
Umfang	p. 1152-1163.
Erscheinungsort	Elsevier Inc.
Dokumenttyp	Artikel ; Online
ZDB-ID	280048-2
ISSN	1938-3207 ; 0002-9165
ISSN (online)	1938-3207
ISSN	0002-9165
DOI	10.1016/j.ajcnut.2023.02.019
Datenquelle	NAL Katalog (AGRICOLA)

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Artikel ; Online: Colon importance in short bowel syndrome.

Lambe, Cecile / Goulet, Olivier / Norsa, Lorenzo

Aging

2019 Band 11, Heft 22, Seite(n) 9961–9962

Mesh-Begriff(e)	Colon/microbiology ; Gastrointestinal Microbiome ; Humans ; Short Bowel Syndrome/microbiology
Sprache	Englisch
Erscheinungsdatum	2019-11-15
Erscheinungsland	United States
Dokumenttyp	Editorial
ISSN	1945-4589
ISSN (online)	1945-4589
DOI	10.18632/aging.102447
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Erythrocyte fatty acid membrane composition in children on long-term parenteral nutrition enriched with ω-3 fatty acids.

Goulet, Olivier / Lamazière, Antonin / Abi Nader, Elie / Talbotec, Cécile / Wolf, Claude / Lambe, Cécile

The American journal of clinical nutrition

2021 Band 115, Heft 2, Seite(n) 422–431

Abstract: Background: Composite lipid emulsions containing soybean oil (30%), medium-chain triglycerides (30%), olive oil (25%), and fish oil (15%) (SMOF) are now widely used.: Objectives: We aimed to evaluate the tolerance, the efficiency, and the erythrocyte ...

Abstract	Background: Composite lipid emulsions containing soybean oil (30%), medium-chain triglycerides (30%), olive oil (25%), and fish oil (15%) (SMOF) are now widely used. Objectives: We aimed to evaluate the tolerance, the efficiency, and the erythrocyte fatty acid (FA) profile for children on long-term home parenteral nutrition (HPN) receiving a composite fish oil-based emulsion (FOLE). Methods: At baseline, children (n = 46) with severe intestinal failure highly dependent on parenteral nutrition (PN) for ≥1 y were included in the study when they had received the composite FOLE for >6 mo. Out of this baseline group, only 25 children remained highly PN-dependent (SMOF1, n = 25) and could be assessed a second time, 2.4 y later (SMOF2, n = 25). An independent control group ("weaned off PN" group; n = 24) included children who had been weaned off PN for >2 y (median: 4 y). RBC-FA composition was established by GC-MS. Growth parameters, plasma citrulline, conjugated bilirubin, FA profiles, and the Holman ratio (20:3ω-9/20:4ω-6) were compared between groups. Results: No difference for growth parameters, citrulline, and bilirubin was observed between the SMOF groups after 2.4 y (0.2 < P < 0.8). The weaned-off group did not differ from the SMOF groups for growth parameters (0.2 < P < 0.4) but citrulline was higher (P < 0.0001) and conjugated bilirubin lower (P < 0.01). The composite FOLE induced higher proportions of EPA (20:5n-3) (8.4% ± 2.9%) and DHA (22:6n-3) (11.7% ± 2.2%) than what was observed in weaned-off children (0.8% ± 0.4% and 6.6% ± 2.3%, respectively) but lower proportions of arachidonic acid (20:4n-6). However, the Holman ratio did not vary between groups (P = 0.9), whereas the PUFA concentrations varied widely. Conclusions: Long-term use of the composite FOLE was well tolerated in HPN-dependent children. The RBC-FA profile alterations were consistent with the ω-3 PUFA-enriched composition of this emulsion without evidence of essential FA deficiency.
Mesh-Begriff(e)	Bilirubin/blood ; Child ; Child, Preschool ; Cross-Sectional Studies ; Erythrocyte Membrane/chemistry ; Fat Emulsions, Intravenous ; Fatty Acids/blood ; Fatty Acids, Omega-3/administration & dosage ; Female ; Fish Oils/administration & dosage ; Food, Fortified ; Humans ; Intestinal Failure/blood ; Intestinal Failure/therapy ; Male ; Olive Oil/administration & dosage ; Parenteral Nutrition, Home/methods ; Soybean Oil/administration & dosage ; Treatment Outcome ; Triglycerides/administration & dosage
Chemische Substanzen	Fat Emulsions, Intravenous ; Fatty Acids ; Fatty Acids, Omega-3 ; Fish Oils ; Olive Oil ; Triglycerides ; Soybean Oil (8001-22-7) ; Bilirubin (RFM9X3LJ49)
Sprache	Englisch
Erscheinungsdatum	2021-09-21
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	280048-2
ISSN	1938-3207 ; 0002-9165
ISSN (online)	1938-3207
ISSN	0002-9165
DOI	10.1093/ajcn/nqab263
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Strategies to Reduce Catheter-Related Bloodstream Infections in Pediatric Patients Receiving Home Parenteral Nutrition: The Efficacy of Taurolidine-Citrate Prophylactic-Locking.

Lambe, Cecile / Poisson, Catherine / Talbotec, Cecile / Goulet, Olivier

JPEN. Journal of parenteral and enteral nutrition

2018 Band 42, Heft 6, Seite(n) 1017–1025

Abstract: Background: Catheter-related bloodstream infections (CRBSIs) remain a major issue in patients who are receiving home parenteral nutrition (HPN). The aim of this interventional study was to assess the impact of a new strategy using taurolidine-citrate (T- ...

Abstract	Background: Catheter-related bloodstream infections (CRBSIs) remain a major issue in patients who are receiving home parenteral nutrition (HPN). The aim of this interventional study was to assess the impact of a new strategy using taurolidine-citrate (T-C) prophylactic locks on the CRBSI rate in children with intestinal failure who are receiving HPN. Methods: The rate of CRBSIs was monitored every calendar year in a prospective cohort of 195 children with intestinal failure. T-C locks were initiated from October 2011 in children with recurring CRBSIs (≥2 episodes per year). Results: In the whole cohort, the median annual CRBSI rate per 1000 catheter days decreased significantly from 2.07 in 2008 to 2010 to 1.23 in 2012 to 2014 (P < .05). T-C locks were used in 40 patients. No adverse events were reported. In taurolidine-treated patients, the CRBSI rate per 1000 catheter days decreased from 4.16 to 0.25 (P < .0001). The cumulative percentage of patients free of CRBSI at 18 months was 92% (95% confidence interval [CI]: 71-98) on T-C lock vs 61% (95% CI: 49-72) in controls (P = .01). In multivariate analysis, factors associated with CRBSI were immune deficiency (adjusted hazard ratio 3.49; 95% CI: 1.01-12.17) and the young age of the parents (adjusted hazard ratio 4.79, 95% CI: 2.16-10.62), whereas T-C locks were protective (adjusted hazard ratio 0.22, 95% CI: 0.06-0.74). Conclusion: This study confirms the efficacy of T-C catheter locks in decreasing the incidence of CRBSIs in children with intestinal failure who are receiving HPN.
Mesh-Begriff(e)	Anti-Infective Agents/therapeutic use ; Calcium Chelating Agents/therapeutic use ; Catheter-Related Infections/prevention & control ; Child ; Child, Preschool ; Citric Acid/therapeutic use ; Cohort Studies ; Female ; France ; Humans ; Infant ; Intestinal Diseases/therapy ; Male ; Parenteral Nutrition, Home/adverse effects ; Prospective Studies ; Taurine/analogs & derivatives ; Taurine/therapeutic use ; Thiadiazines/therapeutic use ; Treatment Outcome
Chemische Substanzen	Anti-Infective Agents ; Calcium Chelating Agents ; Thiadiazines ; Taurine (1EQV5MLY3D) ; Citric Acid (2968PHW8QP) ; taurolidine (8OBZ1M4V3V)
Sprache	Englisch
Erscheinungsdatum	2018-01-31
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	800861-9
ISSN	1941-2444 ; 0148-6071
ISSN (online)	1941-2444
ISSN	0148-6071
DOI	10.1002/jpen.1043
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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