Clinical Management of Intestinal Failure

A complex disease entity, intestinal failure (IF) has only recently become accepted as a distinct clinical syndrome. Improvements across a wide range of disciplines—including critical care and organ transplantation as well as surgical, medical, and nutritional therapies—have led to a steady rise in survival and quality of life for patients with IF. Taking a current, multidisciplinary approach to their care, Clinical Management of Intestinal Failure offers intensive discussion of medical and nutritional issues in adults and children with intestinal failure. It addresses all facets of IF, including epidemiology, clinical presentation, intestinal rehabilitation, and transplantation. Topics covered include: Etiology and epidemiology Pathophysiology and clinical assessment Medical and surgical management Prevention and treatment of complications Nursing management Emerging diagnostic and therapeutic methods Long-term care Reflecting the diverse nature of IF clinical care and research, this book is written by a group of expert clinician scientists that includes gastroenterologists, surgeons, nurses, pharmacists, dietitians, social workers, and patients. They show how a multidisciplinary approach to patient care is instrumental in achieving optimal patient outcomes through more efficient lines of communication, improved monitoring of medications and their effects, detailed evaluation of growth parameters, and facilitation of the creative process that can lead to research breakthroughs. Advancing the discipline of IF, this book summarizes the current state of the art of patient management as well as new developments in the science of tissue engineering, medical and surgical therapy, and transplantation.

Introduction Intestinal FailureEtiology and Epidemiology of Intestinal FailureConrad R. Cole and Thomas R. ZieglerPathophysiology of Intestinal FailureIndraneel Chakrabarty and David L. BurnsMotility Disorders in Intestinal FailureLeonel Rodriguez and Samuel NurkoClinical Assessment of Intestinal Failure in ChildrenJason S. SodenClinical Assessment of Intestinal Failure in AdultsKuang Horng (Jamie) Kang and George BlackburnGastrointestinal Endoscopy and Pathologic FindingsDebora DuroRadiographic EvaluationStephanie DiPerna and Carlo BuonomoMedical and Surgical ManagementPrinciples of Bowel-Preserving SurgeryMilissa A. McKeeMedical and Nutritional ManagementClarivet TorresParenteral Nutrition in ChildrenSharon Collier, Kathleen M. Gura, and Christopher DugganParenteral Nutrition in AdultsM. Molly McMahon, Erin M. Nystrom, and John M. MilesVascular Access DevicesIvan M. Gutierrez, Horacio Padua, and Tom JaksicEnteral AccessSara N. Horst and Douglas L. SeidnerTransition to Enteral NutritionJulie E. Bines and Eva S. NagyDrug Dosing and PharmacokineticsKathleen M. GuraAutologous Intestinal Reconstruction SurgeryMelissa A. Hull, Kristina M. Potanos, Brian A. Jones, and Heung Bae KimIntestinal TransplantationMargaret McGuire, Daniel S. Kamin, and Heung Bae KimCritical Care ManagementNilesh M. Mehta Prevention and Treatment of Complications of Intestinal FailureCentral Venous Catheter Infections: Prevention and TreatmentMary Petrea Cober and Daniel H. TeitelbaumIntestinal Failure–Associated Liver DiseaseIvan R. Diamond and Paul W. WalesUse of Parenteral Fish Oil in the Management of IF–Associated Liver DiseaseErica M. Fallon and Mark PuderOsteopenia and Bone Health in Patients with Intestinal FailureSteven A. AbramsMicronutrient Deficiencies in Intestinal FailureGil HardyBacterial Overgrowth of the Small IntestineEsi S. N. Lamousé-Smith and Samuel KocoshisNursing ManagementOstomy ManagementSandy Quigley and Ellen A. O’DonnellCentral Venous Catheter CareSara Gibbons and Denise S. RichardsonMedication Administration in the Enterally Fed PatientMark G. KlangEmerging Diagnostic and Therapeutic MethodsIntravenous Fat EmulsionsVivian M. Zhao and Thomas R. ZieglerProbiotics and PrebioticsSanjiv Harpavat and Robert J. ShulmanTissue-Engineered IntestineTracy C. GrikscheitAssessment of Mucosal Mass and Hormonal TherapyDavid L. Sigalet and Dana BoctorLong-Term CareHome Parenteral and Enteral NutritionDarlene G. Kelly, John K. DiBaise, and Megan BrennQuality of LifeRobert S. Venick and Khiet D. NgoSocial and Medical Insurance IssuesJulie Iglesias and Stephanie PetruzziOral AversionVirginie ColombA Patient’s PerspectiveJonathan LockwoodEthical Issues in Patient CareDaniel S. KaminSupport GroupsLisa Crosby Metzger, Joan Bishop, and Lyn HowardIndex

Christopher Duggan, MD, MPH, has been performing clinical studies in the fields of pediatric nutrition, gastroenterology, and global health for over 20 years. He is an attending pediatric gastroenterologist and nutrition physician at Children’s Hospital Boston where he directs the Clinical Nutrition Service. He is the medical director of the Center for Advanced Intestinal Rehabilitation, one of the largest centers in the United States for the care of children with intestinal failure/chronic diarrhea syndromes. His funded research efforts include trials of nutrient supplementation in women and children susceptible to infectious diseases in Tanzania, India, and other countries. He is the codirector of the Harvard College course Nutrition and Global Health and mentors undergraduate, graduate, and postdoctoral students at Harvard. He is an associate professor of pediatrics at Harvard Medical School and an associate professor in the Department of Nutrition at Harvard School of Public Health. Kathleen M. Gura, PharmD, BCNSP, FASHP, is the team leader with Surgical Programs and a clinical pharmacist with the Clinical Nutrition Service in the Division of Gastroenterology and Nutrition at Children’s Hospital Boston. She is also an associate professor of pharmacy practice at the Massachusetts College of Pharmacy in Boston. Her professional focus is on academic clinical pharmacy and research, and her areas of expertise include nutritional support for critically ill pediatric patients, nutritional support in intestinal failure, sterile products preparation, aluminum toxicity, and drug–nutrient interactions. Her research in the area of parenteral nutrition–associated liver injury is currently funded by the March of Dimes with additional funding coming from the FDA’s Orphan Drug Development Program. Tom Jaksic, MD, PhD, is the surgical director of the Center for Advanced Intestinal Rehabilitation (CAIR) at Children’s Hospital Boston, vice-chairman of pediatric general surgery at Children’s Hospital Boston, and the W. Hardy Hendren Professor of Surgery at Harvard Medical School. In addition to being a practicing pediatric surgeon he has a PhD in Nutritional Biochemistry from the Massachusetts Institute of Technology (MIT) and has had a career-long research interest regarding the metabolic requirements of critically ill infants as well as the surgical and nutritional management of children with intestinal failure. He is the president-elect of the American Society of Parenteral and Enteral Nutrition (ASPEN).