Gastroenterology – Guidelines on Parenteral Nutrition, Chapter 15

000072 10.3205/000072 urn:nbn:de:0183-0000724 Review Article Gastroenterology – Guidelines on Parenteral Nutrition, Chapter 15 Gastroenterologie – Leitlinie Parenterale Ernährung, Kapitel 15 Schulz Schulz R. J. RJ

Clinic for Geriatrics, St. Marien-Hospital, Cologne, Germany

author Bischoff Bischoff S. C. SC

Dept. Nutritional Medicine and Prevention, University Stuttgart-Hohenheim, Germany

author Koletzko Koletzko B. B

Dept. Metabolic Diseases & Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich, Germany

author Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine author German Medical Science GMS Publishing House

Düsseldorf

610 inflammatory bowel disease Crohn's disease ulcerative colitis pancreatitis chronisch entzündliche Darmerkrankungen Morbus Crohn Colitis ulcerosa Pankreatitis Special Issue 20090114 20091118 engl 1612-3174 7 GMS German Medical Science GMS Ger Med Sci 13 Eine parenterale Ernährung (PE) ist indiziert bei Patienten mit Morbus Crohn oder Colitis ulcerosa, wenn eine enterale Ernährung nicht möglich ist bzw. aus medizinischen Gründen vermieden werden sollte. Bei Morbus Crohn Patienten kann eine PE bei Manifestation im oberen Dünndarm und Ileus- und Subileussymptomatik, Narben oder Darmfisteln indiziert sein. Die PE bedarf keiner speziellen Zusammensetzung für chronisch entzündliche Darmerkrankungen. In beiden Erkrankungen sollte sich die PE aus 55–60% Kohlenhydraten, 25–30% Fett und 10–15% Aminosäuren zusammensetzen. Die PE unterstützt die Korrektur der Mangelernährung, vor allem die Aufnahme von Energie, Mineralstoffen, Spurenelementen, Mangel an Kalzium, Vitamin D, Folsäure, Vitamin B 12, Zink. Im Falle einer notwendigen künstlichen Ernährung bei einer schweren akuten Pankreatitis ist eine enterale Ernährung einer parenteralen Ernährungsform eindeutig überlegen. Eine Unverträglichkeit der enteralen Ernährung führt bei Komplikationen, wie Pseudozysten, intestinale und pankreatische Fisteln, pankreatische Abszesse oder pankreatischem Aszites zum Einsatz der TPE. Sollte eine enterale Ernährung nicht möglich sein, ist eine PE erst nach frühestens 5 Tagen nach Klinikeintreffen zu empfehlen. Die TPE sollte bei milder akuter Pankreatitis, Nahrungskarenz <7 Tage, nicht routinemäßig verabreicht werden, aufgrund steigender Kosten und erhöhtem Infektionsrisiko. Der Energiebedarf liegt zwischen 25 und 35 kcal/kg KG/Tag. Bei akuter Pankreatitis kann eine Standardlösung inklusive Fett verabreicht werden (Monitoring der Triglyzeridspiegel!). Glukose von max. 3–6 g/kg KG/Tag und Aminosäuren von 1,2–1,5 g/kg KG/Tag sollten zugeführt werden sowie eine zusätzliche Anreicherung durch Glutamin von TPE sollte bei schweren Verlaufsformen einer Pankreatitis erwogen werden. In patients with Crohn's disease and ulcerative colitis parenteral nutrition (PN) is indicated when enteral nutrition is not possible or should be avoided for medical reasons. In Crohn's patients PN is indicated when there are signs/symptoms of ileus or subileus in the small intestine, scars or intestinal fistulae. PN requires no specific compounding for chronic inflammatory bowel diseases. In both diseases it should be composed of 55–60% carbohydrates, 25–30% lipids and 10–15% amino acids. PN helps in the correction of malnutrition, particularly the intake of energy, minerals, trace elements, deficiency of calcium, vitamin D, folic acid, vitamin B12, and zinc. Enteral nutrition is clearly superior to PN in severe, acute pancreatitis. An intolerance to enteral nutrition results in an indication for total PN in complications such as pseudocysts, intestinal and pancreatic fistulae, and pancreatic abscesses or pancreatic ascites. If enteral nutrition is not possible, PN is recommende</PlainText></TextGroup>d, at the earliest, 5 days after admission to the hospital. TPN should not be routinely administered in mild acute pancreatitis or nil by moth status <7 days, due to high costs and an increased risk of infection. The energy requirements are between 25 and 35 kcal/kg body weight/day. A standard solution including lipids (monitoring triglyceride levels!) can be administered in acute pancreatitis. Glucose (max. 4–5 g/kg body weight/day) and amino acids (about 1.2–1.5 g/kg body weight/day) should be administered and the additional enrichment of TPN with glutamine should be considered in severe, progressive forms of pancreatitis.</Pgraph> </Abstract> <TextBlock linked="yes" name="Crohn's disease"> <MainHeadline>Crohn's disease</MainHeadline> <SubHeadline>Indication and time of parenteral nutrition (PN)</SubHeadline> <Pgraph> <UnorderedList> <ListItem level="1">PN is indicated when enteral nutrition is not possible or should be avoided for medical reasons (A).</ListItem> <ListItem level="1">PN is indicated when there are signs/symptoms of ileus or subileus in the small intestine, scars or intestinal fistulae (C). </ListItem> </UnorderedList> </Pgraph> <SubHeadline>Substrate intake</SubHeadline> <Pgraph> <UnorderedList> <ListItem level="1">PN requires no specific compounding for chronic inflammatory bowel diseases.</ListItem> <ListItem level="1">It should be composed of 55–60% carbohydrates, 25–30% lipids and 10–15% amino acids (A). No conclusive data is available on the use of admixtures in the form of polyunsaturated fatty acids (C). </ListItem> <ListItem level="1">PN helps in the correction of malnutrition, particularly the intake of energy, minerals, trace elements, deficiency of calcium, vitamin D, folic acid, vitamin B12, and zinc (A).</ListItem> </UnorderedList> </Pgraph> <SubHeadline>Commentary</SubHeadline> <Pgraph>Once the use of PN has been decided upon, a PN solution should be used due to the high incidence of malnutrition in chronic inflammatory bowel disease. PN should be administered via central venous access for osmolarity over 800 mosmol/l and continuously over 24 hours.</Pgraph> <Pgraph>The daily parenteral energy intake in well-nourished adult patients should amount to 25–30 kcal/kg body weight. During the first 24–48 hours, the PN administration should be slowly started with a phase of an “up-titration”, starting with about 50% of the energy amount. The volume should be adjusted to 30–40 ml/kg body weight, depending on the loss of fluid. Concentrations of 4–6 g glucose/kg body weight, 1.5–2 g lipids per kg body weight and 1.5–2 g amino acids per kg body weight are recommended <TextLink reference="1"></TextLink>.</Pgraph> <Pgraph>PN is indicated in cases of toxic megacolon, malabsorption syndrome, particularly short bowel syndrome, insufficient growth and disturbance of growth in children as well as when enteral nutrition is not tolerated <TextLink reference="2"></TextLink>, <TextLink reference="3"></TextLink>, <TextLink reference="4"></TextLink>, <TextLink reference="5"></TextLink>, <TextLink reference="6"></TextLink>, <TextLink reference="7"></TextLink>, <TextLink reference="8"></TextLink>, <TextLink reference="9"></TextLink>, <TextLink reference="10"></TextLink>. </Pgraph> <Pgraph>PN presents no advantage if the disease is chronically active (A). An increased rate of remission is not achieved with PN, according to the official recommendations of the American Gastroenterological Association (AGA). PN has no influence on the surgical intervention rate. Acc<TextGroup><PlainText>ordin</PlainText></TextGroup>g to these recommendations, it is not necessary to bypass the intestinal passage to attain clinical remission.</Pgraph> <Pgraph>An optimal supply of nutrients improves bowel motility, intestinal permeability and nutritional status, and lowers inflammatory reactions <TextLink reference="8"></TextLink>, <TextLink reference="11"></TextLink>. Malnutrition often occurs in patients with inflammatory bowel diseases. There are extensive differences in the parameters for malnutrition between Crohn’s disease and ulcerative colitis. Malnutrition is diagnosed in 80% of Crohn's disease patients <TextLink reference="5"></TextLink>, <TextLink reference="9"></TextLink>, <TextLink reference="10"></TextLink>, <TextLink reference="11"></TextLink>. The severity of malnutrition depends on the duration of the illness, activity of the inflammation, the function of the small intestine and extent of the diseased sections in the small intestine, and results in a higher incidence of protein energy malnutrition as well as specific substrate deficiency. </Pgraph> <Pgraph>Clinical symptoms, inflammatory and nutritional parame<TextGroup><PlainText>ter</PlainText></TextGroup>s in Crohn's disease can improve under enteral/oral nutrition <TextLink reference="2"></TextLink>, <TextLink reference="6"></TextLink>, <TextLink reference="10"></TextLink>, <TextLink reference="12"></TextLink>, <TextLink reference="13"></TextLink>, <TextLink reference="14"></TextLink>. There is no standardised data available regarding the remission rate with PN. It was found that in complicated cases, remission could be more easily attained through PN than with enteral nutrition <TextLink reference="15"></TextLink>. </Pgraph> <Pgraph>Total PN is an important therapy in children and teenagers <TextLink reference="5"></TextLink>. </Pgraph> <Pgraph>In terms of wound healing and reconstitution of the small intestine, PN shows no advantages as compared to enteral nutrition. It is assumed that oral/enteral nutrition provides faster stability in organ function of the small intestine.</Pgraph> <Pgraph>Complications like venous thromboses, occlusion of the central venous vessels, sepsis, cholestasis/cholangitis/cholecystitis, cholestatic liver dysfunction are associated with TPN <TextLink reference="16"></TextLink>, <TextLink reference="17"></TextLink>, <TextLink reference="18"></TextLink>, <TextLink reference="19"></TextLink>, <TextLink reference="20"></TextLink>, <TextLink reference="21"></TextLink>, <TextLink reference="22"></TextLink>, <TextLink reference="23"></TextLink>, <TextLink reference="24"></TextLink>, <TextLink reference="25"></TextLink>, <TextLink reference="26"></TextLink>, <TextLink reference="27"></TextLink>. Acute elevation in transaminases, overall bilirubin and albumin are characteristics of PN metabolic complications <TextLink reference="16"></TextLink>, <TextLink reference="17"></TextLink>, <TextLink reference="18"></TextLink>, <TextLink reference="19"></TextLink>, <TextLink reference="20"></TextLink>, <TextLink reference="21"></TextLink>, <TextLink reference="22"></TextLink>, <TextLink reference="24"></TextLink>, <TextLink reference="25"></TextLink>.</Pgraph> <Pgraph>Numerous studies show that catheter-related sepsis occur on an average once or twice every two years in patients on long-term PN who are suffering from a functional short bowel syndrome, as a result of chronic inflammatory bowel diseases. Recurring catheter infections with septic components occur during hospital stays in dependence of central access catheter models and in dependence of training and care standards in the hospital in patients who are not receiving long-term PN <TextLink reference="28"></TextLink>. There are no advantages of PN therapy over enteral nutrition therapy regarding fistula healing. No differences can be seen in the rate of survival.</Pgraph> </TextBlock> <TextBlock linked="yes" name="Ulcerative colitis"> <MainHeadline>Ulcerative colitis</MainHeadline> <SubHeadline>Indication and time of PN</SubHeadline> <Pgraph> <UnorderedList> <ListItem level="1">PN is indicated when enteral nutrition is not possible or should be avoided for medical reasons (A).</ListItem> </UnorderedList> </Pgraph> <SubHeadline>Substrate intake</SubHeadline> <Pgraph> <UnorderedList> <ListItem level="1">PN requires no specific compounding for chronic inflammatory bowel diseases (A).</ListItem> <ListItem level="1">It should be composed of 55–60% carbohydrates, 25–30% lipids and 10–15% amino acids (A). No conclusive data is available on the use of admixtures in the form of polyunsaturated fatty acids (C).</ListItem> <ListItem level="1">PN helps in the correction of malnutrition, particularly the intake of energy, minerals, trace elements, deficiency of calcium, vitamin D, folic acid, vitamin B12, and zinc (A). In addition, the intake of vitamins, trace elements and minerals can be orally or intravenously substituted irrespective of PN.</ListItem> </UnorderedList> </Pgraph> <SubHeadline>Commentary</SubHeadline> <Pgraph>No significant improvement in clinical parameters was observed in patients with ulcerative colitis with the use of PN <TextLink reference="2"></TextLink>, <TextLink reference="29"></TextLink>. There is no standardised data available regarding the remission rate with PN. It was also observed that, in complicated cases, remission could be more easily attained with PN than with enteral nutrition <TextLink reference="15"></TextLink>. </Pgraph> <Pgraph>Total PN is an important therapy in children and teenagers <TextLink reference="5"></TextLink>.</Pgraph> <Pgraph>In terms of wound healing and the reconstitution of the small intestine, PN shows no advantages compared to enteral nutrition. It is assumed that oral/enteral nutrition provides faster stability in organ function of the small intestine.</Pgraph> <Pgraph>Complications like venous thrombosis, occlusion of the central venous vessels, sepsis, cholestasis/cholangitis/cholecystitis, cholestatic liver dysfunction are associated with TPN <TextLink reference="16"></TextLink>, <TextLink reference="17"></TextLink>, <TextLink reference="19"></TextLink>, <TextLink reference="20"></TextLink>, <TextLink reference="21"></TextLink>, <TextLink reference="22"></TextLink>, <TextLink reference="24"></TextLink>, <TextLink reference="25"></TextLink>, <TextLink reference="30"></TextLink>. </Pgraph> <Pgraph>Acute increase in transaminases, overall bilirubin and albumin are characteristics of metabolic complications of PN <TextLink reference="16"></TextLink>, <TextLink reference="17"></TextLink>, <TextLink reference="19"></TextLink>, <TextLink reference="20"></TextLink>, <TextLink reference="21"></TextLink>, <TextLink reference="22"></TextLink>, <TextLink reference="24"></TextLink>, <TextLink reference="25"></TextLink>, <TextLink reference="30"></TextLink>.</Pgraph> <Pgraph>There are no advantages of PN therapy over enteral nutrition therapy regarding fistula healing. No differences can be seen in the rate of survival.</Pgraph> </TextBlock> <TextBlock linked="yes" name="Acute pancreatitis"> <MainHeadline>Acute pancreatitis</MainHeadline> <SubHeadline>Indication and time of PN</SubHeadline> <Pgraph> <UnorderedList> <ListItem level="1">Enteral nutrition is clearly superior to PN in severe, acute pancreatitis (A). </ListItem> <ListItem level="1">An intolerance to enteral nutrition results in an indication for total PN in complications such as pseudocysts, intestinal and pancreatic fistulae, and pancreatic abscesses or pancreatic ascites (B).</ListItem> <ListItem level="1">If enteral nutrition is not possible, PN is recommended, at the earliest, 5 days after admission to the hospital (C).</ListItem> <ListItem level="1">TPN should be not be routinely administered in mild acute pancreatitis or nil by moth status <7 days, due to high costs and an increased risk of infection (C).</ListItem> </UnorderedList> </Pgraph> <SubHeadline>Commentary</SubHeadline> <Pgraph>The nutritional therapy of acute pancreatitis depends on the severity of the disease, presence of any complications and nutritional state of the patient. Enteral transduodenal feeding should be started once acute pancreatitis is suspected. There is a clear benefit with enteral nutrition in numerous studies <TextLink reference="31"></TextLink>, <TextLink reference="32"></TextLink>, <TextLink reference="33"></TextLink>, <TextLink reference="34"></TextLink>, <TextLink reference="35"></TextLink>, <TextLink reference="36"></TextLink>, <TextLink reference="37"></TextLink>, <TextLink reference="38"></TextLink>, <TextLink reference="39"></TextLink>, <TextLink reference="40"></TextLink>, <TextLink reference="41"></TextLink> regarding LOS, infection-related morbidity and possible organ failures. Total PN should be started only when there are contraindications to enteral nutrition or no possible access. </Pgraph> <Pgraph>The time to start should be after the resolution of the acute phase in acute, complicated forms of pancreatitis <TextLink reference="42"></TextLink>, <TextLink reference="43"></TextLink>. A prospective, controlled and randomised study on acute pancreatitis <TextLink reference="44"></TextLink> shows that exclusive TPN results in a longer LOS and increase in costs with no improvement regarding the course of disease. </Pgraph> <Pgraph>Recent studies have shown that enteral nutrition through a jejunal tube can be of an advantage in specific patient groups <TextLink reference="45"></TextLink>, <TextLink reference="46"></TextLink>, <TextLink reference="47"></TextLink>, <TextLink reference="48"></TextLink>. A similarly positive effect is also achieved by using nasogastric tubes, but in a smaller study <TextLink reference="49"></TextLink>.</Pgraph> <Pgraph>Jejunal feeding is assessed to be safe and effective in the postoperative stage in severe forms of pancreatitis, according to the study by Pupelis <TextLink reference="45"></TextLink>. TPN is presumed to prevent stimulation of the exocrine pancreas as well as help in the maintenance of metabolic homeostasis in severe forms of pancreatitis <TextLink reference="17"></TextLink>, <TextLink reference="30"></TextLink>. In severe cases (presence of ileus), the task of TPN is to compensate for the increased protein expenditure, as well as to maintain the nutrition state of the patient. PN reduces mortality and improves the nutritional situation in such circumstances <TextLink reference="50"></TextLink>, <TextLink reference="51"></TextLink>, and is to be continued until a stable, haemodynamic state is achieved <TextLink reference="52"></TextLink>, <TextLink reference="53"></TextLink>. </Pgraph> <Pgraph>The lack of utilisation of the intestine in acute pancreatitis seems to worsen the metabolic stress situation, lengthen the LOS and increase the risk of complications <TextLink reference="31"></TextLink>, <TextLink reference="34"></TextLink>, <TextLink reference="40"></TextLink>, <TextLink reference="46"></TextLink>, <TextLink reference="54"></TextLink>, <TextLink reference="55"></TextLink>. Further evidence indicates that not only enteral nutrition, but also specific nutritional components in enteral nutrition such as probiotics, arginine, glutamine and antioxidants have a positive influence on LOS and the rate of complications <TextLink reference="56"></TextLink>, <TextLink reference="57"></TextLink>. </Pgraph> <SubHeadline>Energy intake</SubHeadline> <Pgraph> <UnorderedList> <ListItem level="1">The energy requirements lie in a range between 25 and 35 kcal/kg body weight/day <TextLink reference="16"></TextLink> (A). </ListItem> </UnorderedList> </Pgraph> <SubHeadline>Substrate intake</SubHeadline> <Pgraph> <UnorderedList> <ListItem level="1">A standard solution including lipids can be administered in acute pancreatitis (C). Lipids can be administered to meet energy requirements and should be subject to regular monitoring (triglycerides).</ListItem> <ListItem level="1">Carbohydrates are the most important energy source. Glucose administration (max. 4–5 g/kg body weight/day) counteracts intrinsic gluconeogenesis, and prevents protein degradation. Administering glucose instead of lipids, as an energy supplier, lowers the potential risk of hyperlipidemia, but lipid administration cannot be avoided in most cases (B). </ListItem> <ListItem level="1">An even nitrogen balance can be achieved and maintained with amino acids. The intake of amino acids should be about 1.2–1.5 g/kg body weight/day (A). </ListItem> <ListItem level="1">The additional enrichment of TPN with glutamine should be considered in severe, progressive forms of pancreatitis, thereby improving the clinical progression (B). </ListItem> <ListItem level="1">The intravenous administration of lipid emulsions is safe, as long as triglyceride levels (<400 mg/dl) are monitored (C). Statements on particularly beneficial fatty acid admixtures cannot be made regarding pancreatitis.</ListItem> </UnorderedList> </Pgraph> <SubHeadline>Commentary</SubHeadline> <Pgraph>McClave et al. <TextLink reference="44"></TextLink> carried out a study in 1997, in which 30 patients received either total PN or total enteral nutrition. No differences between the two groups were observed with regards to mortality, level of pain in the period until amylase levels normalised, serum albumin levels and the frequency of nosocomial infections. Significantly more hyperglycaemia occurred in the total PN group <TextLink reference="34"></TextLink>.</Pgraph> <Pgraph>Tests on fatty acid admixtures are at present only available for “Intralipid” solutions and are deemed safe for administration <TextLink reference="58"></TextLink>.</Pgraph> <Pgraph>The glucose admixture was modified in 2 studies <TextLink reference="58"></TextLink>, <TextLink reference="59"></TextLink> based on the clinical picture of stress-induced hyperglycaemia. In the study carried out by Wu <TextLink reference="58"></TextLink>, initial h<TextGroup><PlainText>ype</PlainText></TextGroup>rg<TextGroup><PlainText>lycaemi</PlainText></TextGroup>a was reported in 64% of patients, which was easier to control with a lipid/glucose admixture than in a pure glucose admixture. Hypertriglyceridemia, or negative effects on the liver function, were not reported. Significant differences regarding the glucose levels, cholesterol levels or uric acid levels were also not rep<TextGroup><PlainText>orte</PlainText></TextGroup>d in Martinez' work <TextLink reference="59"></TextLink>.</Pgraph> <Pgraph>De Beaux et al. <TextLink reference="60"></TextLink> carried out a study of 14 patients with acute pancreatitis, where one group received standardised PN and the other group received nutrition enriched with glutamine. The glutamine group showed increased lymphocyte proliferation, an increase in T-cell DNA as well as a drop in an interleukin 8 concentration. The administration of glutamine could be beneficial in preventing complications. A lower rate of complications and significantly lower rates of pancreatic infections were also described with glutamine in the papers by Ockenga et al. <TextLink reference="61"></TextLink> and Xian et al. <TextLink reference="62"></TextLink>. Patients with acute pancreatitis show an increased rate of catheter-sepsis and metabolic dysfunctions. The administration of thiamine, folic acid, magnesium and zinc is recommended in patients with a history of alcohol abuse <TextLink reference="17"></TextLink>, <TextLink reference="63"></TextLink>. </Pgraph> <Pgraph>Patients with severe diseases and complications require early enteral nutritional therapy to prevent detrimental effects caused by nutritional losses (especially proteins) <TextLink reference="32"></TextLink>, <TextLink reference="36"></TextLink>, <TextLink reference="64"></TextLink>. Some authors recommend early jejunal nutrition with an elementary diet and others recommend TPN combined with enteral nutrition <TextLink reference="65"></TextLink>. PN should only be used in complicated cases when ileus is present or probable with regular checks for glucose, triglycerides and serum pH.</Pgraph> </TextBlock> <TextBlock linked="yes" name="Notes"> <MainHeadline>Notes</MainHeadline> <Pgraph>This article is part of the publication of the Guidelines on Parenteral Nutrition from the German Society for Nutritional Medicine (overview and corresponding address under <Hyperlink href="http://www.egms.de/en/journals/gms/2009-7/000086.shtml">http://www.egms.de/en/journals/gms/2009-7/000086.shtml</Hyperlink>).</Pgraph> <Pgraph>English version edited by Sabine Verwied-Jorky, Rashmi Mittal and Berthold Koletzko, Univ. of Munich Medical Centre, Munich, Germany.</Pgraph> </TextBlock> <References linked="yes"> <Reference refNo="1"> <RefAuthor>Buchman AL</RefAuthor> <RefAuthor>Scolapio J</RefAuthor> <RefAuthor>Freyer J</RefAuthor> <RefTitle>AGA technical review on short bowel syndrome and intestinal transplantation</RefTitle> <RefYear>2003</RefYear> <RefJournal>Gastroenterol</RefJournal> <RefPage>1111-34</RefPage> <RefTotal>Buchman AL, Scolapio J, Freyer J. 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