ABSTRACT

Medical management of patients with intestinal failure (IF) is rooted in three well-established principles: maximize enteral feedings, minimize parenteral feedings, and avoid infections. Enteral feedings are maximized according to the simple adage “if the gut works, use it,” in an effort to promote weight gain and intestinal adaptation. Parenteral feedings are minimized to prevent central line complications as well as parenteral nutrition-associated (PN) cholestasis. Infections-caused by microbes translocating across the gut wall or colonizing venous catheters-are avoided to give fragile IF patients uninterrupted opportunities to grow [1-3].