Beltran, Nemie

Jafri, Syed-Mohammed

Muszkat, Yakir

Nagai, Shunji

Qasawa, Austin H

English

Henry Ford Health System Scholarly Commons

Henry Ford Health Henry Ford Health Scholarly Commons Gastroenterology Meeting Abstracts Gastroenterology 7-1-2021 Quality of trace mineral monitoring and replacement for patients on teduglutide for short bowel syndrome Austin H. Qasawa Nemie Beltran Henry Ford Health, NBELTRA1@hfhs.org Shunji Nagai Henry Ford Health, snagai1@hfhs.org Yakir Muszkat Henry Ford Health, ymuszka1@hfhs.org Syed-Mohammed Jafri Henry Ford Health, sjafri3@hfhs.org Follow this and additional works at: https://scholarlycommons.henryford.com/gastroenterology_mtgabstracts Recommended Citation Qasawa A, Beltran N, Nagai S, Muszkat Y, and Jafri S. Quality of trace mineral monitoring and replacement for patients on teduglutide for short bowel syndrome. Transplantation 2021; 105(7 SUPPL 1):S71. This Conference Proceeding is brought to you for free and open access by the Gastroenterology at Henry Ford Health Scholarly Commons. It has been accepted for inclusion in Gastroenterology Meeting Abstracts by an authorized administrator of Henry Ford Health Scholarly Commons. Downloadedfromhttp://journals.lww.com/transplantjournalbyBhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws=on08/26/2021Downloadedfromhttp://journals.lww.com/transplantjournalbyBhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws=on08/26/2021© 2021 Wolters Kluwer  S71AbstractsP-44Prophylactic Anticoagulation in Children Receiving Home Parenteral NutritionNagelkerke S1, Schoenmaker M2, Tabbers M1, Benninga M1,  van Ommen H3, Gouw S41Emma Children’s Hospital, Amsterdam UMC, Department of Pediatric Gastroenterology, Hepatology and Nutrition, 2Amsterdam UMC, University of Amsterdam, 3Erasmus University Medical Center, Sophia Children’s Hospital, Department of Pediatric Hematology, 4Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Department of Pediatric HematologyIntroduction: Children with intestinal failure are dependent on long-term intravenous administration of home parenteral nutrition. They are at risk of loss of vascular access due to catheter-related venous thrombosis. Whether prophylactic anticoagulation is effective and safe in preventing catheter-related thrombosis is largely unknown. Our aim was to assess the incidences of catheter-related venous thrombosis and bleeding complications in children with intestinal failure on home parenteral nutrition treated with prophylactic anticoagulation.Methods: All children, aged 0-18 years, treated with home parenteral nutri-tion at the Emma Children’s Hospital / Amsterdam UMC were followed from January 2004 - July 2019. All patients were offered prophylactic anticoagula-tion from the start of home parenteral nutrition. The primary outcomes were catheter-related venous thrombosis and bleeding on prophylactic anticoagu-lation. Ethical clearance was obtained for this study.Results: In total, 64 (89%) of 74 patients received prophylactic anticoagula-tion. Eight (11%) patients who did not receive prophylaxis and 2 patients with a malignancy were excluded. The median age at start of home parenteral nutrition was 7.5 months (IQR 4.2 – 47.9) and the median age at start of prophylaxis was 7.6 months (IQR 4.7 – 51.7). Patients were followed for a median of 32.2 months (IQR 13.8 – 58.1), with a total of 86,656 cath-eter days. At the start of the study 60 (94%) patients were treated with low molecular weight heparin, 3 patients (5%) with oral vitamin K antagonists and 1 patient with unfractionated heparin. During follow-up, 13 patients switched from LMWH to VKAs. A total of 12 patients developed 18 catheter-related thromboses. The incidence of catheter-related thromboses on prophylactic anticoagulation was 0.2 per 1000 catheter days. In total, 23 clinically rel-evant bleeds occurred, corresponding with 0.3 clinically relevant bleedings per 1000 catheter days. Median time to first event was 1268 days (IQR 566 – 2276) for thrombosis and 1139 days (IQR 364 – 2831) for clinically relevant bleeding. Cumulative event free survival after 5 years was 76% for catheter-related thrombosis.Conclusions: Our study shows low rates of catheter-related venous throm-bosis and of clinically relevant bleeding in children with home parenteral nutri-tion receiving prophylactic anticoagulation.P-45Quality of Trace Mineral Monitoring and Replacement for Patients on Teduglutide for Short Bowel SyndromeQasawa A1, Beltran N2, Nagai S2, Muszkat Y2, Jafri S21Wayne State University School Of Medicine, 2Henry Ford Health SystemIntroduction: We evaluated serum levels of trace minerals including zinc, copper, and selenium in patients with short bowel syndrome (SBS) taking teduglutide. We worked to see if trace mineral values were being monitored and corrected.Methods: We performed a retrospective review to identify patients with SBS on teduglutide. We obtained data for two years following initiation for moni-toring of serum levels for zinc, copper, and selenium. We identified if supple-mentation was needed and initiated with improvement.Results: Of the 148 patients evaluated for SBS, 19 were on teduglutide. Mean age was 53 years (range 28-76), 79% female, 63% Caucasian, 16% Black. 31.6% (n=19), 42.1% (n=19), and 42.1% (n=19) never had any screen-ing of zinc, copper, and selenium respectively over the two year period. At baseline, 15.8% (n=19), 10.5% (n=19), and 10.5% (n=19) of patients had screening for zinc, copper, and selenium respectively. Of those checked no patients had a mineral deficiency at baseline. At 6 months, 31.6% (n=19), 31.6% (n=19), and 26.3% (n=19) had screening for zinc, copper, and sele-nium respectively. There were documented deficiencies of zinc (33.3%), cop-per (33.3%) and selenium (20%) in those checked at 6 months. Of those with documented deficiencies there was replacement in 62.5% of patients. Less patients were being monitored at 12 months, 18 months and 24 months respectively (Table 1).Conclusion: This study indicates that there is a lack of trace mineral monitoring in patients taking teduglutide for SBS. In those being moni-tored there was a clear pattern of deficiencies being found by 6 months after initiation requiring repletion. Without adequate monitoring, it is dif-ficult to know if patients are deficient in trace minerals and if supple-mentation is needed. Thorough monitoring is crucial to avoiding ongoing deficiencies.Trace MineralTime Interval  (months)Percent  CheckedMineral DeficiencyZinc Baseline 15.80% 0% 6 31.60% 33.30% 12 26.70% 25% 18 26.70% 0% 24 14.30% 0%Copper Baseline 10.50% 0% 6 31.60% 33.30% 12 20% 0% 18 26.70% 25% 24 14.30% 50%Selenium Baseline 10.50% 0% 6 26.30% 20% 12 26.70% 0% 18 26.70% 0% 24 14.30% 0%

Quality of trace mineral monitoring and replacement for patients on teduglutide for short bowel syndrome

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Quality of trace mineral monitoring and replacement for patients on teduglutide for short bowel syndrome

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