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| From: | Fri Nov 30 0:00:00 PST 2012 |
| To: | Fri Nov 30 8:00:00 PST 2012 |
| ecuimchiefs | Join us for #ecuimres #grandrounds this morning. Dr. Matarese presents: Intestinal Failure: Salvaging the Remnant Bowel | |
| ecuimchiefs | #ecuimres #grandrounds Short Bowel Syndrome = most common form of intestinal failure | |
| ecuimchiefs | #ecuimres #grandrounds Treatment of SBS: Parenteral & Enteral Nutrition vs Intestinal Rehab. Dr Matarese to focus on advantages of latter | |
| ecuimchiefs | #ecuimres #grandrounds Complications of Parenteral Nutrition: reduced qual of life, catheter sepsis, vasc thrombosis, liver dz, bone dz | |
| ecuimchiefs | #ecuimres #grandrounds TPN is also very COSTLY. | |
| ecuimchiefs | #ecuimres #grandrounds Prognosis for PN avoidance declines based on retained bowel (see image) http://t.co/CbTZHYbg | |
| ecuimchiefs | #ecuimres #grandrounds "Intestinal Adaptation" - Morphological changes causing functional changes leading to increased intestinal absorption | |
| ecuimchiefs | #ecuimres #grandrounds Intestinal Rehab: comprehensive management http://t.co/3u1MfNXB | |
| ecuimchiefs | #ecuimres #grandrounds Do not give 'Gatorade' type oral rehydration to short gut patients bc there is not enough sodium in these solutions. | |
| ecuimchiefs | #ecuimres #grandrounds Inappropriate Dietary Choices in SBS pts: simple sugars (soft drinks, candies, etc.) | |
| ecuimchiefs | #ecuimres #grandrounds Nutrient Intake in Patients with SBS http://t.co/qinf3LL5 | |
| ecuimchiefs | #ecuimres #grandrounds Adjunctive Medical Mgmt for SBS: http://t.co/bPOiEELZ | |
| ecuimchiefs | #ecuimres #grandrounds No data supporting use of pancreatic enzyme supplementation, but it is sometimes used. | |
| ecuimchiefs | #ecuimres #grandrounds Dr. Matarese cautions use of Octreotide in these pts. | |
| ecuimchiefs | #ecuimres #grandrounds Hormonal Therapy may "revolutionize therapy in SBS" - Dr. Matarese. | |
| ecuimchiefs | #ecuimres #grandrounds Growth Hormone (Zorbtive) and Teduglutide (Gattex) are the 2 up and coming therapies. | |
| ecuimchiefs | #ecuimres #grandrounds Growth Hormone and SBS studies: Dr. Seguy et al http://t.co/R9aFdsH0 | |
| ecuimchiefs | #ecuimres #grandrounds Glucagon-like peptide 2 (GLP-2) has several physiologic properties that would help pts with SBS to enhance absorption | |
| ecuimchiefs | #ecuimres #grandrounds Supporting evidence for GLP-2 agonist: http://t.co/qdzIKJTB | |
| ecuimchiefs | #ecuimres #grandrounds Follow-up phase 2 trial (Teduglutide): http://t.co/Kl17AYD7 | |
| ecuimchiefs | #ecuimres #grandrounds Phase 3 trial: http://t.co/EyzgkhKR | |
| ecuimchiefs | #ecuimres #grandrounds Another therapeutic option is Surgical Augmentation, ie: Bianchi Procedure (primarily peds model) and STEP Procedure | |
| ecuimchiefs | #ecuimres #grandrounds STEP Procedure creates a zigzag channel from dilated bowel loops -->lengthening small bowel length | |
| ecuimchiefs | #ecuimres #grandrounds Therapeutic Algorithm for #SmallBowelSyndrome (image) http://t.co/9qUrKDXO |
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