• Nutrition · Jun 2023

    Long-term home parenteral nutrition in systemic sclerosis-related intestinal failure is feasible but unveils occult cardiac disease.

    • Benoit Suzon, Sophie Rivière, Auelie Schiffmann, Valérian Rivet, Nicolas Flori, Philippe Guilpain, and Alexandre Thibault Jacques Maria.
    • Department of Internal Medicine, Martinique University Hospital, Martinique, France; EpiCliV Research Unit, University of the French West Indies, Fort-de-France, Martinique, France.
    • Nutrition. 2023 Jun 1; 110: 112009112009.

    ObjectiveThe aim of this study was to compare safety and efficacy of long-term home parenteral nutrition between patients with systemic sclerosis and intestinal failure (IF) and controls with IF from another etiology.MethodsA retrospective study was conducted in a referral center for systemic sclerosis (SSc) in Montpellier, France. Patients followed between 1985 and 2020 with SSc-related IF were included and compared with control patients with IF from another etiology. The patients included had to be treated for ≥4 wk by home parenteral nutrition (HPN). Primary outcome was occurrence of HPN-related complications. Secondary outcomes included duration of parenteral nutrition, body mass index at 12 mo, and survival.ResultsCumulative duration of HPN was 23 397 catheter days. HPN resulted in body mass index increase in both groups. There was no statistical difference regarding catheter-related bloodstream infections and thrombosis between the groups, despite use of immunosuppressive drugs and autologous hematopoietic stem cell transplantation in patients with SSc. However, the patients with SSc had significantly more HPN-related cardiac overload than the controls (P < 0.0001). Overloads occurred in SSc patients with and without cardiac disease, arguing for comprehensive hemodynamic screening in this condition.ConclusionLong-term HPN in SSc-related IF is feasible but unveils occult cardiac disease.Copyright © 2023 Elsevier Inc. All rights reserved.

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