Strategies for parenteral nutrition weaning in adult patients with short bowel syndrome

John K. DiBaise, Laura E. Matarese, Bernard Messing, Ezra Steiger

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

The development of parenteral nutrition (PN) was an important, life-saving advance in the care of patients with short bowel syndrome (SBS). Nevertheless, its long-term use is often associated with complications. Therefore, it is desirable, when possible, to wean SBS patients to an oral diet. Given the complexity of PN weaning and the lack of published guidelines, the purpose of this article is to describe strategies of PN weaning and illustrate important clinical considerations during the weaning process. Patient education and motivation are key factors in successful PN weaning. The patient should have clearly defined care protocols and understand the importance of each aspect of the weaning program. Other factors likely to influence weaning success include the length and health of the remnant bowel, the presence of a colon, and the degree to which bowel adaptation has occurred. It is imperative that daily oral fluid and caloric intake goals are met prior to initiating PN weaning and that the patient receives an optimized dietary and medication plan. During weaning, the most practical measures for assessing adequate hydration and nutritional status are oral intake, stool and urine output, serum electrolytes and visceral proteins, and body weight. PN reductions can be made by either decreasing the days of PN infusion per week or decreasing the PN infusion volume equally across all days of the week. Use of recombinant human growth hormone, with or without glutamine, may play a role in facilitating the PN weaning process.

Original languageEnglish (US)
JournalJournal of Clinical Gastroenterology
Volume40
Issue numberSUPPL. 2
DOIs
StatePublished - May 2006

Fingerprint

Short Bowel Syndrome
Parenteral Nutrition
Weaning
Parenteral Infusions
Nutritional Physiological Phenomena
Human Growth Hormone
Patient Education
Energy Intake
Glutamine
Nutritional Status
Electrolytes
Growth Hormone
Patient Care
Colon
Body Weight
Urine
Guidelines
Diet

Keywords

  • Management
  • Parenteral nutrition
  • Short bowel syndrome
  • Weaning

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Strategies for parenteral nutrition weaning in adult patients with short bowel syndrome. / DiBaise, John K.; Matarese, Laura E.; Messing, Bernard; Steiger, Ezra.

In: Journal of Clinical Gastroenterology, Vol. 40, No. SUPPL. 2, 05.2006.

Research output: Contribution to journalArticle

DiBaise, John K. ; Matarese, Laura E. ; Messing, Bernard ; Steiger, Ezra. / Strategies for parenteral nutrition weaning in adult patients with short bowel syndrome. In: Journal of Clinical Gastroenterology. 2006 ; Vol. 40, No. SUPPL. 2.
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