الإدارة من الخط الأول لمتلازمة القصور المعوي: الترطيب، والتغذية، وتقليل الاعتماد على التغذية الوريدية

References

DOI: 10.1016/j.cgh.2022.05.032

• Virtually all patients with SBS require PN support in the initial period following resection, and few will be able to discontinue the PN prior to their discharge from the hospital.
• PN should be initiated and adjusted to meet the patient's fluid, electrolyte, energy, protein, and micronutrient needs.
• Because most adult patients with SBS have significant malabsorption, dietary intake must be increased by at least 50% from their estimated needs (ie, hyperphagic diet).
• The use of antisecretory medications, including proton pump inhibitors or histamine-2 receptor antagonists, is beneficial in reducing the volume of gastric secretions, the damaging effects of the acid on the upper gut mucosa and the function of pancreatic exocrine enzymes.
• Fluids should be given to compensate for all losses and maintain a urine output of at least 1 L/d.
• Adequate hydration is generally based on a goal urine output of >1 L/d and a urinary sodium concentration >20 mEq/L.
• The amount of PN can be decreased when the patient demonstrates the ability to take oral nutrition without excessive stool or ostomy output and with appropriate weight maintenance or gain.