1st Edition

Clinical Management of Intestinal Failure

    564 Pages 113 B/W Illustrations
    by CRC Press

    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 Failure

    Etiology and Epidemiology of Intestinal Failure
    Conrad R. Cole and Thomas R. Ziegler

    Pathophysiology of Intestinal Failure
    Indraneel Chakrabarty and David L. Burns

    Motility Disorders in Intestinal Failure
    Leonel Rodriguez and Samuel Nurko

    Clinical Assessment of Intestinal Failure in Children
    Jason S. Soden

    Clinical Assessment of Intestinal Failure in Adults
    Kuang Horng (Jamie) Kang and George Blackburn

    Gastrointestinal Endoscopy and Pathologic Findings
    Debora Duro

    Radiographic Evaluation
    Stephanie DiPerna and Carlo Buonomo

    Medical and Surgical Management


    Principles of Bowel-Preserving Surgery
    Milissa A. McKee

    Medical and Nutritional Management
    Clarivet Torres

    Parenteral Nutrition in Children
    Sharon Collier, Kathleen M. Gura, and Christopher Duggan

    Parenteral Nutrition in Adults
    M. Molly McMahon, Erin M. Nystrom, and John M. Miles

    Vascular Access Devices
    Ivan M. Gutierrez, Horacio Padua, and Tom Jaksic

    Enteral Access
    Sara N. Horst and Douglas L. Seidner

    Transition to Enteral Nutrition
    Julie E. Bines and Eva S. Nagy

    Drug Dosing and Pharmacokinetics
    Kathleen M. Gura

    Autologous Intestinal Reconstruction Surgery
    Melissa A. Hull, Kristina M. Potanos, Brian A. Jones, and Heung Bae Kim

    Intestinal Transplantation
    Margaret McGuire, Daniel S. Kamin, and Heung Bae Kim

    Critical Care Management
    Nilesh M. Mehta

    Prevention and Treatment of Complications of Intestinal Failure

    Central Venous Catheter Infections: Prevention and Treatment
    Mary Petrea Cober and Daniel H. Teitelbaum

    Intestinal Failure–Associated Liver Disease
    Ivan R. Diamond and Paul W. Wales

    Use of Parenteral Fish Oil in the Management of IF–Associated Liver Disease
    Erica M. Fallon and Mark Puder

    Osteopenia and Bone Health in Patients with Intestinal Failure
    Steven A. Abrams

    Micronutrient Deficiencies in Intestinal Failure
    Gil Hardy

    Bacterial Overgrowth of the Small Intestine
    Esi S. N. Lamousé-Smith and Samuel Kocoshis

    Nursing Management

    Ostomy Management
    Sandy Quigley and Ellen A. O’Donnell

    Central Venous Catheter Care
    Sara Gibbons and Denise S. Richardson

    Medication Administration in the Enterally Fed Patient
    Mark G. Klang

    Emerging Diagnostic and Therapeutic Methods

    Intravenous Fat Emulsions
    Vivian M. Zhao and Thomas R. Ziegler

    Probiotics and Prebiotics
    Sanjiv Harpavat and Robert J. Shulman

    Tissue-Engineered Intestine
    Tracy C. Grikscheit

    Assessment of Mucosal Mass and Hormonal Therapy
    David L. Sigalet and Dana Boctor

    Long-Term Care


    Home Parenteral and Enteral Nutrition
    Darlene G. Kelly, John K. DiBaise, and Megan Brenn

    Quality of Life
    Robert S. Venick and Khiet D. Ngo

    Social and Medical Insurance Issues
    Julie Iglesias and Stephanie Petruzzi

    Oral Aversion
    Virginie Colomb

    A Patient’s Perspective
    Jonathan Lockwood

    Ethical Issues in Patient Care
    Daniel S. Kamin

    Support Groups
    Lisa Crosby Metzger, Joan Bishop, and Lyn Howard

    Index

    Biography

    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).