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Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression

The management of enterocutaneous fistulas (ECF) can be challenging because of massive fluid loss, which can lead to electrolyte imbalance, severe dehydration, malnutrition and sepsis. Nutritional support plays a key role in the management and successful closure of ECF. The principle of nutritional...

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Autores principales: Tang, Qin-qing, Hong, Zhi-wu, Ren, Hua-jian, Wu, Lei, Wang, Ge-fei, Gu, Guo-sheng, Chen, Jun, Zheng, Tao, Wu, Xiu-wen, Ren, Jian-an, Li, Jie-shou
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573310/
https://www.ncbi.nlm.nih.gov/pubmed/33123545
http://dx.doi.org/10.3389/fnut.2020.564379
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author Tang, Qin-qing
Hong, Zhi-wu
Ren, Hua-jian
Wu, Lei
Wang, Ge-fei
Gu, Guo-sheng
Chen, Jun
Zheng, Tao
Wu, Xiu-wen
Ren, Jian-an
Li, Jie-shou
author_facet Tang, Qin-qing
Hong, Zhi-wu
Ren, Hua-jian
Wu, Lei
Wang, Ge-fei
Gu, Guo-sheng
Chen, Jun
Zheng, Tao
Wu, Xiu-wen
Ren, Jian-an
Li, Jie-shou
author_sort Tang, Qin-qing
collection PubMed
description The management of enterocutaneous fistulas (ECF) can be challenging because of massive fluid loss, which can lead to electrolyte imbalance, severe dehydration, malnutrition and sepsis. Nutritional support plays a key role in the management and successful closure of ECF. The principle of nutritional support for patients with ECF should be giving enteral nutrition (EN) priority, supplemented by parenteral nutrition if necessary. Although total parenteral nutrition (TPN) may be indicated, use of enteral feeding should be advocated as early as possible if patients are tolerant to it, which can protect gut mucosal barrier and prevent bacterial translocation. A variety of methods of enteral nutrition have been developed such as fistuloclysis and relay perfusion. ECF can also be occluded by special devices and then EN can be implemented, including fibrin glue application, Over-The-Scope Clip placement and three-dimensional (3D)-printed patient-personalized fistula stent implantation. However, those above should not be conducted in acute fistulas, because tissues are edematous and perforation could easily occur.
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spelling pubmed-75733102020-10-28 Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression Tang, Qin-qing Hong, Zhi-wu Ren, Hua-jian Wu, Lei Wang, Ge-fei Gu, Guo-sheng Chen, Jun Zheng, Tao Wu, Xiu-wen Ren, Jian-an Li, Jie-shou Front Nutr Nutrition The management of enterocutaneous fistulas (ECF) can be challenging because of massive fluid loss, which can lead to electrolyte imbalance, severe dehydration, malnutrition and sepsis. Nutritional support plays a key role in the management and successful closure of ECF. The principle of nutritional support for patients with ECF should be giving enteral nutrition (EN) priority, supplemented by parenteral nutrition if necessary. Although total parenteral nutrition (TPN) may be indicated, use of enteral feeding should be advocated as early as possible if patients are tolerant to it, which can protect gut mucosal barrier and prevent bacterial translocation. A variety of methods of enteral nutrition have been developed such as fistuloclysis and relay perfusion. ECF can also be occluded by special devices and then EN can be implemented, including fibrin glue application, Over-The-Scope Clip placement and three-dimensional (3D)-printed patient-personalized fistula stent implantation. However, those above should not be conducted in acute fistulas, because tissues are edematous and perforation could easily occur. Frontiers Media S.A. 2020-10-06 /pmc/articles/PMC7573310/ /pubmed/33123545 http://dx.doi.org/10.3389/fnut.2020.564379 Text en Copyright © 2020 Tang, Hong, Ren, Wu, Wang, Gu, Chen, Zheng, Wu, Ren and Li. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Nutrition
Tang, Qin-qing
Hong, Zhi-wu
Ren, Hua-jian
Wu, Lei
Wang, Ge-fei
Gu, Guo-sheng
Chen, Jun
Zheng, Tao
Wu, Xiu-wen
Ren, Jian-an
Li, Jie-shou
Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression
title Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression
title_full Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression
title_fullStr Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression
title_full_unstemmed Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression
title_short Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression
title_sort nutritional management of patients with enterocutaneous fistulas: practice and progression
topic Nutrition
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573310/
https://www.ncbi.nlm.nih.gov/pubmed/33123545
http://dx.doi.org/10.3389/fnut.2020.564379
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