title: Long-term nutritional assessment of patients with severe short bowel syndrome managed with home enteral nutrition and oral intake.
abstract: BACKGROUND
  Parenteral nutrition (PN) is used to control the nutritional state after severe intestinal resections. Whenever possible, enteral nutrition (EN) is used to promote intestinal rehabilitation and reduce PN dependency. Our aim is to verify whether EN + oral intake (OI) in severe short bowel syndrome (SBS) surgical adult patients can maintain adequate nutritional status in the long term.
  
  
  METHODS
  This longitudinal retrospective study included 10 patients followed for 7 post-operative years. Body mass index (BMI), percentage of involuntary loss of usual body weight (UWL), free fat mass (FFM), and fat mass (FM) composition assessed by bioelectric impedance, and laboratory tests were evaluated at 6, 12, 24, 36, 48, 60, 72, and 84 months after surgery. Energy and protein offered in HPN and at long term by HEN+ oral intake (OI), was evaluated at the same periods. The statistical model of generalized estimating equations with p < 0,05 was used.
  
  
  RESULTS
  With long term EN + OI there was a progressive increase in the UWL, a decrease in BMI, FFM, and FM (p < 0,05). PN weaning was possible in eight patients. Infection due to central venous catheter (CVC) contamination was the most common complication (1.2 episodes CVC/patient/year). There was an increase in energy and protein intake supply provided by HEN+OI (p < 0.05). All patients survived for at least 2 years, seven for 5 years and six for 7 years of follow-up.
  
  
  CONCLUSIONS
  In the long term SBS surgical adult patients fed with HEN+OI couldn't maintain adequate nutritional status with loss of FM and FFM.
authors.affiliation: GANEP, Nutrição Humana, São Paulo, Brazil. viviane@ganep.com.br
authors.forename: V
authors.initials: V
authors.lastname: Chaer Borges
authors.forename: M de L
authors.initials: Mde L
authors.lastname: Teixeira da Silva
authors.forename: M C
authors.initials: MC
authors.lastname: Gonçalves Dias
authors.forename: M C
authors.initials: MC
authors.lastname: González
authors.forename: D
authors.initials: D
authors.lastname: Linetzky Waitzberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001823:Body Composition; D050218:Body Fat Distribution; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D055499:Catheter-Related Infections / Q000209:etiology; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D016331:Parenteral Nutrition, Home / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D013534:Survival; D016896:Treatment Outcome; D055815:Young Adult