Three years' experience with an intestinal failure unit

Abstract

The work of a purpose-built unit for the treatment of intestinal failure is described. In the 3 years following its opening the 4-bed unit treated 83 patients who were admitted for a mean of 35 days. Major indications for admission were difficult cases of Crohn's disease, intestinal fistulae and short bowel syndrome. Since the unit opened the mortality rate in this type of patient has fallen from 42% to 20%. The principal treatment used was total parenteral nutrition (TPN) although 52 of the 83 patients also required major surgery. Repeated experience with the same type of clinical problem has led to more efficient patient management and has reduced the complication rate associated with TPN. The unit has acted as a centre for the management of patients needing Home Parenteral Nutrition and has an active role in training nursing and medical staff in intravenous therapy. A plea is made for the establishment of regional intestinal failure units.