424 Early Outcomes of the Insides Chyme Reinfuser (ICR) in the Management of High-Output Stoma

Abstract

Abstract Aim High-output stomas present a significant surgical, nursing, nutritional and patient challenge. Patients are at risk of complications ranging from disrupted GI and renal physiology to severe complications from vascular access. The ICR device allows chyme to be reinfused and may be a promising way to establish early enteral feeding, shorten hospital stays, and reduce complications such as significant GI losses and prolonged parenteral feeding. We aimed to investigate the early outcome of ICR in our initial cohort of patients. Method Prospective analysis of all patients using ICR from 2020-2022. Outcomes included: primary pathology, hospital stay, duration of Parenteral nutrition, albumin level, commencement and tolerance of Chyme reinfusion, and mortality. Results Eight patients used ICR. Five became independent in using the device. Four were successfully reversed with one waiting reversal. In all patients, a significant reduction in using parenteral nutrition was noted as five patients were nutritionally autonomous whilst using ICR. Although an imperfect marker, albumin levels responded to ICR use (an average improvement from 31g/L to 38g/L). One patient died due to complications from the primary pathology. Conclusions The ICR device is safe and effective. It can be used by nursing patients and most patients. Our data suggest a possible reduction in TPN use which will have financial and clinical benefits. The ICR device should be considered in selected patients. There remains considerable mortality in patients with significant co-morbidity who are left with a high-output stoma.