title: ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults.
abstract: OBJECTIVE
  Intestinal failure (IF) is not included in the list of PubMed Mesh terms, as failure is the term describing a state of non functioning of other organs, and as such is not well recognized. No scientific society has yet devised a formal definition and classification of IF. The European Society for Clinical Nutrition and Metabolism guideline committee endorsed its "home artificial nutrition and chronic IF" and "acute IF" special interest groups to write recommendations on these issues.
  
  
  METHODS
  After a Medline Search, in December 2013, for "intestinal failure" and "review"[Publication Type], the project was developed using the Delphi round methodology. The final consensus was reached on March 2014, after 5 Delphi rounds and two live meetings.
  
  
  RESULTS
  The recommendations comprise the definition of IF, a functional and a pathophysiological classification for both acute and chronic IF and a clinical classification of chronic IF. IF was defined as "the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth".
  
  
  CONCLUSIONS
  This formal definition and classification of IF, will facilitate communication and cooperation among professionals in clinical practice, organization and management, and research.
authors.affiliation: Center for Chronic Intestinal Failure, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: loris.pironi@unibo.it.
authors.forename: Loris
authors.initials: L
authors.lastname: Pironi
authors.affiliation: Tumor Biology Center, Albert-Ludwigs-University, Freiburg, Germany.
authors.forename: Jann
authors.initials: J
authors.lastname: Arends
authors.affiliation: Tayside Nutrition Managed Clinical Network, Dundee, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Baxter
authors.affiliation: Faculty of Medicine, University of Milan, Milan, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Bozzetti
authors.affiliation: Nutritional Support Unit, University Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Rosa Burgos
authors.initials: RB
authors.lastname: Peláez
authors.affiliation: Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Cuerda
authors.affiliation: University of East Anglia, Norwich Research Park, Norwich, UK.
authors.forename: Alastair
authors.initials: A
authors.lastname: Forbes
authors.affiliation: The Lennard-Jones Intestinal Failure Unit, St Mark's Hospital and Academic Institute, Harrow, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Gabe
authors.affiliation: National Intestinal Failure Service, Auckland City Hospital (AuSPEN), Auckland, New Zealand.
authors.forename: Lyn
authors.initials: L
authors.lastname: Gillanders
authors.affiliation: Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Holst
authors.affiliation: Rigshospitalet, Department of Gastroenterology, Copenhagen, Denmark.
authors.forename: Palle Bekker
authors.initials: PB
authors.lastname: Jeppesen
authors.affiliation: Centre for Intestinal Failure, Department of Gastroenterology and Nutritional Support, Hôpital Beaujon, Clichy, France.
authors.forename: Francisca
authors.initials: F
authors.lastname: Joly
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota and Oley Foundation for Home Parenteral and Enteral Nutrition, Albany, NY, USA.
authors.forename: Darlene
authors.initials: D
authors.lastname: Kelly
authors.affiliation: General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland.
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Klek
authors.affiliation: Dept. of Gastroenterologic Surgery, University Hospital North-Norway, Tromso, Norway.
authors.forename: Øivind
authors.initials: Ø
authors.lastname: Irtun
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: S W
authors.initials: SW
authors.lastname: Olde Damink
authors.affiliation: Department for Perioperative Nutrition, Clinic for General Surgery, Military Medica Academy, Belgrade, Serbia.
authors.forename: Marina
authors.initials: M
authors.lastname: Panisic
authors.affiliation: Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Henrik Højgaard
authors.initials: HH
authors.lastname: Rasmussen
authors.affiliation: Rigshospitalet, Department of Gastroenterology, Copenhagen, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Staun
authors.affiliation: General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland.
authors.forename: Kinga
authors.initials: K
authors.lastname: Szczepanek
authors.affiliation: Medico-Surgical Department of Gastroenterology, Hôpital Erasme, Free University of Brussels, Belgium.
authors.forename: André
authors.initials: A
authors.lastname: Van Gossum
authors.affiliation: Intestinal Failure Unit, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Geert
authors.initials: G
authors.lastname: Wanten
authors.affiliation: Gastroenterology and Clinical Nutrition, CHU of Nice, University of Nice Sophia Antipolis, Nice, France.
authors.forename: Stéphane Michel
authors.initials: SM
authors.lastname: Schneider
authors.affiliation: Intestinal failure Unit, Salford Royal Hospital, Salford, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Shaffer
mesh_terms: D000208:Acute Disease; D000328:Adult; D002908:Chronic Disease; D005060:Europe; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology; D007410:Intestinal Diseases / Q000145:classification* / Q000175:diagnosis / Q000178:diet therapy*; D010288:Parenteral Nutrition / Q000379:methods*; D012958:Societies, Scientific / Q000592:standards*
keywords: Chronic intestinal pseudo-obstruction; Enterocutaneous fistulas; Home parenteral nutrition; Intestinal failure; Intestinal transplantation; Short bowel syndrome