A comparison of chyme reinfusion therapy methods: Two case studies

TL;DR

This paper compares two methods of chyme reinfusion therapy for intestinal failure, finding that a pump-assisted approach is safer and more accepted than manual therapy.

Contribution

The study introduces pump-assisted CRT as a promising alternative to manual CRT for managing intestinal failure.

Findings

Manual CRT was unpopular and caused frequent interruptions.

Pump-assisted CRT was safe, well-tolerated, and accepted by caregivers.

Pump-assisted CRT may offer physiological advantages over parenteral nutrition.

Abstract

High output enterostomy associated malnutrition is a feature of intestinal failure (IF). Chyme reinfusion therapy (CRT) is recommended for restoration of physiological digestive processes in type 2 IF patients. Nevertheless, widespread use of manual CRT has limitations. Recently, innovative technology has demonstrated enhanced intestinal absorption and decreased intestinal losses, associated with improved nutritional and clinical outcomes.

A pilot comparison of pump-assisted versus manual CRT was conducted on two short bowel syndrome (SBS) cases using a check list and key informant interviews.

Manual CRT was unpopular among nurses and caregivers, causing frequent interruptions in the procedure. Alternatively, pump-assisted CRT was safe, well tolerated by the patients and accepted by caregivers. The automated system has physiological advantages over parenteral nutrition (PN) with relatively few complications. It could be a cost effective and valuable addition to IF nutritional management but requires verification in a larger planned comparative study.