title: Intestinal failure management at the Cleveland Clinic.
abstract: The Cleveland Clinic institutional guidelines for the management of intestinal failure, including long-term or home parenteral nutrition and related complications, intestinal rehabilitation, and small bowel transplantation, were reviewed. PubMed was searched for relevant articles. The search was performed in November 2008; keywords used were home parenteral nutrition, short bowel syndrome, intestinal rehabilitation, and small-bowel transplantation. Randomized, prospective, observational, retrospective reviews and case report articles that contained relevant data for long-term parenteral nutrition, intestinal rehabilitation, and intestinal transplantation were selected. Researchers reviewed 67 selected articles that met our inclusion criteria. Our institution data registries for intestinal rehabilitation and home parenteral nutrition were also reviewed for relevant data. The survival of tens of thousands of children and adults with complicated gastrointestinal problems has been possible because of parenteral nutrition. In selected patients, a program of intestinal rehabilitation may avoid the need for long-term parenteral nutrition.
authors.affiliation: Desk A100 Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Shatnawei
authors.forename: Neha R
authors.initials: NR
authors.lastname: Parekh
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Rhoda
authors.forename: Rex
authors.initials: R
authors.lastname: Speerhas
authors.forename: Judy
authors.initials: J
authors.lastname: Stafford
authors.forename: Vijaya
authors.initials: V
authors.lastname: Dasari
authors.forename: Cristiano
authors.initials: C
authors.lastname: Quintini
authors.forename: Donald F
authors.initials: DF
authors.lastname: Kirby
authors.forename: Ezra
authors.initials: E
authors.lastname: Steiger
mesh_terms: D000046:Academic Medical Centers; D003266:Continuity of Patient Care; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D007422:Intestines / Q000637:transplantation; D008134:Long-Term Care; D008297:Male; D009751:Nutritional Requirements; D009752:Nutritional Status; D016331:Parenteral Nutrition, Home / Q000009:adverse effects / Q000379:methods; D010289:Parenteral Nutrition, Total / Q000009:adverse effects / Q000379:methods*; D010351:Patient Discharge; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D012778:Short Bowel Syndrome / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome