Highlights from the 2022 BAPEN Annual Conference

BAPEN’s Programmes Committee Members; Pete Turner (Chair) and Jennie Mort (Sovereign Conference) along with Lovesh Dyall (BAPEN Medical Trainees), Jeremy Nightingale and Dr Simon Gabe (BIFA), Tony Murphy (BPNG), Akshay Batra (BSPGHAN), Georgie Adams (NNNG), Rebekah Smith (PENG), Carolyn Wheatley (PINNT), Joanna Pulman (Renal Nutrition Specialist Group) report on the BAPEN 2022 Annual Conference.

Deferred for two years, we were delighted to be able to hold the BAPEN 2022 Annual Conference at the Hilton Brighton Metropole as a face-to-face event. Attracting record numbers of over 600 attendees, the Conference offered delegates an extensive range of clinical and scientific topics relevant to both acute and community settings, providing over 14 symposia, the Pennington and Keynote Lectures, the Nutricia breakfast symposium, and two satellite symposia sponsored by Abbott and Takeda. The Conference enabled delegates to hear of cutting-edge and innovative practice with an abundance of practical take home messages to facilitate improvements in the delivery of nutritional care back in the workplace. With the introduction of the Conference Sustainability Statement, we were delighted to offer delegates a Conference app and e-Posters, kindly supported by Aymes and Stanningley Pharma respectively. These were a great addition to an already well-respected and organised Conference.

Whilst it is not possible to describe all of the sessions in detail, this review provides insight into some of the Conference highlights as reported by members of the BAPEN Programmes Committee and Core Group representatives.

Dr Trevor Smith, BAPEN President, opened the Conference highlighting ‘BAPEN’s vision to ensure every individual received safe, timely and appropriate nutritional care in every care setting, every day’, and launched the new 5-year BAPEN Strategy, which sets out ambitious plans for growth in membership, reach, impact, knowledge, and longevity for BAPEN. Developed over eighteen months, reflecting the modern landscape of healthcare, providing a sharp focus for disease related malnutrition, its core values remain a reminder to us all working in the discipline of clinical nutrition: “Listen, Lead, Share and Support”. Three pillars underpin these values, providing a road map for the next five years: • Knowledge • Reach • Sustainability. To find out more, click here.

The opening symposium, Good Morning BAPEN continued with a pre-recorded presentation from the Emeritus Professor of Clinical Nutrition & Metabolism at the Faculty of Medicine, Southampton, Professor Marinos Elia, who presented on the NHS screening tool of choice, award-winning 'MUST’ – from the past to the future’. Dr Sorrel Burden kicked off by highlighting the James Lind Alliance Research Priority Setting Partnership (JLA-PSP) on Nutritional Screening and Malnutrition, which identified the top ten priorities for research within this space.¹ In this JLA-PSP nutritional screening in the community was high up on the list of priorities. This was the impetus for a literature review that was undertaken and discussed, outlining the paucity in the evidence base of large scale studies that detailed the prevalence and incidence of malnutrition in community dwelling older adults.² This set the scene for a big data project that used the UK Biobank involving over 380,000 participants, and showed the prevalence of malnutrition to be estimated at over 16% in the UK population.³ Further data was presented that showed that people at a moderate or high risk of malnutrition using the ‘Malnutrition Universal Screening Tool’ (‘MUST’) had a higher rate of mortality than people who were at a low risk of malnutrition using ‘MUST’. Future plans were discussed, including the launch of a ‘MUST’ app to make screening more accessible to community-based health and social care professionals in the UK.

^{References: • Jones DJ, et al. (2020) Priority setting for adult malnutrition and nutritional screening in healthcare: a James Lind Alliance. J Hum Nutr Diet.; 33(2): 274-283. • Almohaisen N, et al. (2022) Prevalence of Undernutrition, Frailty and Sarcopenia in Community-Dwelling People Aged 50 Years and Above: Systematic Review and Meta-Analysis. Nutrients.; 14(8): 1537. • AlMohaisen N, et al. (In press). Inter-relationship between risk of undernutrition, frailty and sarcopenia in older people using UK Biobank data. Clin Nutr ESPEN.}

This led nicely into Dr Rebecca Stratton, Chair of BAPEN’s Malnutrition Action Group (MAG) presenting on the ‘Highlights of the BAPEN Malnutrition and Nutritional Care Survey’, stating: “Together we must transform the identification and management of malnutrition to improve lives and reduce the burden on care and society.”

This session concluded with Carolyn Wheatley, Chair of PINNT and Dr Simon Gabe, Consultant Gastroenterologist, St Mark’s Hospital, presenting the ‘Story of Short Bowel Syndrome (SBS)’. They outlined what home parenteral nutrition (HPN) with SBS is like for people who depend on it, touching on innovation that has improved quality of life but does not take away the burden of illness and treatment. The story has remained the same for many years, however the short bowel regime now needs to incorporate consideration of intestinal growth factors. GLP-2 analogues are intestinotrophic and have been shown to improve intestinal absorption and reduce parenteral nutrition requirements in patients with short bowel syndrome. It’s a new chapter for patients whose views must be considered when the potential for exciting new medications is discussed as an option.

Distal Enteral Feeding, chaired by BIFA members Dr Simon Gabe and Alison Young, provided an interesting symposium with international speakers. Professor Gil Hardy, Emeritus Professor of Clinical Nutrition, Massey University, Auckland, New Zealand, talked about the physiology of chyme reinfusion in a distal segment of bowel and how this has advantages over using a sterile enteral feed, altering the microbiome and also enhancing drug absorption. A new device to enable chyme reinfusion was also presented, which has the potential to allow chyme reinfusion to become a more standard treatment in patients with disconnected distal bowel and intestinal fistulae. Kirstine Farrer, Consultant Dietitian – Intestinal Failure from Salford Care Organisation, described the advantages of chyme reinfusion in patients with intestinal failure with some practical tips. The oral communication ‘Chyme Reinfusion for Double Enterostomy: A preliminary real-life experience with a novel reinfusion device’ from Dr Sabrina Layec from France, presented some preliminary experience using the novel reinfusion device in a small number of patients and assessing outcomes. The symposium concluded with The Pam Harris Lecture, awarded to Jose Bennell from the Royal Free London Hospitals NHS Foundation Trust, who presented data on catheter-related blood stream infections in the time of Covid-19. This highlighted that catheter-related blood stream infections rose significantly during the pandemic and decreased afterwards. The symposium was well received and there was good interaction between the speakers and the audience.

The BSPGHAN symposium, Optimising Nutrition in Young People with Neurodisability, chaired by Akshay Batra and Jemma Cleminson, focused mainly on nutritional management in children and young adults with neurodisability. The first talk entitled ‘Gastrointestinal Dysfunction in Children and Young People with Neurodisability: Assessment and management,’ was an excellent introduction to the topic by Professor Mark Beattie, Consultant Paediatric Gastroenterologist, Southampton Children’s Hospital, and discussed the prevalence of the condition with common challenges faced in management. It was followed by a very informative session on ‘Blended Diet and its Role in Improving Enteral Tolerance in your People with Severe Neurodisability’ presented by Amanda Wall and Chloe Moore from East Lancashire Teaching Hospital, who talked about the practicalities and benefits of using a blended diet in this group. This was a very helpful guide to setting up a local service providing blended diets in hospitals and in the community. This was followed by Joanna Elverston, Consultant in Palliative Medicine from Newcastle upon Tyne Hospitals, who presented the process of transition of care from paediatric to adult services and strategies to improve the experience for patients and their families. Lastly, Elena Cernat, Consultant Paediatric Gastroenterologist, Leeds Children’s Hospital NHS Trust, presented ‘Ethical Dilemmas Around the Use of Long-Term Parenteral Nutrition in Severe Neurodisability’ highlighting her experience of using parenteral nutrition (PN) in children and young adults and the ethical issues arising from its use. This session was very well received and generated a lively discussion.

A NICE Look at MEED: Refeeding in eating disorders and complex gastrointestinal dysmotilities outlined that The Royal College of Psychiatrists recently highlighted a 79% increase in the number of adults admitted to acute medical wards with eating disorders (ED) so the symposium aimed to look at the new Medical Emergencies in Eating Disorders (MEED) guidelines specifically from the perspective of management on general, gastroenterology, endocrinology and critical care wards rather than specialist ED units.

Gastroenterologist and BAPEN President Dr Trevor Smith gave a fascinating overview of the fine line between eating disorders and complex dysmotilities, illustrating conditions such as gastroparesis, IBS functional dyspepsia with case studies and demonstrating the close relationship with EDs such Avoidant/Restrictive Food Intake Disorder (ARFID). His take home messages included:

• These patients are REALLY challenging to manage
• Gastric emptying studies may be limited value
• Precision when reporting and interpreting gastric emptying studies
• Multidisciplinary team (MDT) approach to care is key
• Massive gap in the provision of mental healthcare – every gastroenterologist needs a psychiatrist!
• Jejunal feeding may have a role in a very small proportion of patients
• HPN is associated with harm in many of these patients.

Pete Turner, Specialist Dietitian at the Ulster Hospital looked at the challenges of managing ED patients in district general hospital and the implications of MEED particularly in respect to refeeding syndrome and electrolyte replacement with the following key messages:

• Most patients admitted to acute medical units will be at high risk of refeeding syndrome according to both the general criteria in National Institute for Health and Care Excellence (NICE) CG32 and ED specific MEED
• Perhaps too much emphasis has been placed on the number calories to give on day 1 when it should be on the rate of build up so that full requirements are met by days 4 -7
• The start low (approx. 10 kcal/kg) and build up swiftly approach avoids the risk of massive early electrolyte shifts while avoiding the underfeeding syndrome or prolonged periods on low energy intake
• In order to do this generous prophylactic provision of electrolytes in conjunction with energy provision is required to correct the massive intracellular depletion of K, Mg and Po4 these patients often have
• Sodium excretion ceases in refeeding and ED patients are at very high risk of sodium and fluid overload
• Caution should be taken with the MEED recommendation of following local policies for electrolyte provision as many of these advocate giving them in large volumes of 0.9% saline which can be particularly dangerous
• Use or enteral electrolyte preparations where possible
• If IV electrolytes are required, these should ideally be given on an HDU or specialist unit that can give them in concentrated form.

Following an excellent oral communication entitled ‘Eating Disorders in London: A service evaluation’ presented by Dr Andrew Rochford from Royal Free London Hospitals NHS Foundation Trust, Dr Penny Neild and Dr Irina Grecu presented a fascinating case study with input from Professor Paul Robinson, Dr Alastair McKinlay, Trevor Smith, Priya Mistry and Pete Turner. The case demonstrated how an anorexia nervosa patient became fluid overloaded on a general ward through inappropriate IV fluid and electrolyte provision, requiring admission to an intensive care unit (ICU) for continuous positive airway pressure (CPAP). Expert nasogastric (NG) feeding and electrolyte provision allowed her to survive and eventually flourish with an MDT approach and psychiatric input.

The BPNG led symposium Evolving World of Parenteral Nutrition chaired by Tony Murphy commenced with Regional Pharmacy Procurement Specialist – London, Guy’s and St Thomas NHS Foundation Trust, Jackie Eastwood’s talk providing an update on PN capacity and reviewed the current issues re: accessing sufficient aseptic capacity within the NHS and from commercial aseptic compounding companies. This presentation covered the national documents that have led to the formation of an aseptic strategy by the Infusions and Special Medicines Programme that is being driven forward at national, regional and local levels. National standardisation PN is on the workplan, so there was a plea for BAPEN members to lead in this area. Sarah Zeraschi, Consultant Pharmacist for Nutrition at Leeds Teaching Hospitals NHS Trust reviewed the implementation of a standardised approach to PN within the hospitals in Leeds. The scope included neonates and paediatrics. The project was very successful with over 80% of neonates and 60% of paediatric patients prescribed PN as multi-chamber bags (MCBs). Significant improvements in growth rate were noted in patients following implementation. Sarah highlighted the current challenges to rolling out the use of MCBs in homecare. Simon Harrison, Specialist Pharmacist – Intestinal Failure, Northern Care Alliance NHS Foundation Trust, used case studies to consider how multiple infusions can be used to supplement MCBs. The Intestinal Failure Unit at Salford Royal Hospital have estimated that 36% of adult patients on fully compounded PN could have utilised MCBs with concurrent IV fluid supplementation. Simon outlined some of the techniques used and explained that the approach was often outside licensed indications, making the sharing of stability/compatibility information more difficult. This symposium concluded with an oral communication, ‘Licensed Multi-chamber Parenteral Nutrition with administration of separate Intravenous Micronutrients in Critical Care,’ presented by Moira Dawson from University Hospitals of Leicester NHS Trust, which was awarded the Best Oral Communication.

BAPEN Medical Trainees delivered the symposium IBD and nutrition in adults chaired by Lovesh Dyall from St Mark’s Hospital, opened with ‘Dietary Landscapes in Inflammatory Bowel Disease: The importance of role of the diet in IBD’ highlighted by the enigmatic Professor Kevin Whelan, King’s College London with his succinct, and efficient overview. ‘Converting Exclusive Enteral Nutrition to Food-Based Therapy for Crohn’s Disease,’ Professor Konstantinos Gerasimidis, Professor of Clinical Nutrition, School of Medicine, University of Glasgow gave us an insight into a novel therapeutic diet in IBD with solid foods: CD-TREAT! Kathleen McGrath, Gastroenterology Dietitian, St Mark’s Hospital, presenting ‘Practicalities of Administering Dietary Therapy in IBD Patients,’ gave us a real insight into putting all of these into practice balancing the challenges, whilst helping our patients with their quality of life. The symposium concluded with the oral communication ‘A Cross-Sectional Survey of Gastroenterology Trainees in the United Kingdom: Experiences, confidence and satisfaction in Nutrition Training’ presented by Stephanie Sartain, University Hospital Southampton NHS Trust.

Alison Young delivered this year’s prestigious Pennington Lecture, an inspiring lecture detailing her amazing career as a nutrition nurse consultant culminating in her winning the British Journal of Nursing Nutrition Nurse of the Year in 2018. After joining the Royal Liverpool University Hospital (RLUH) nutrition team, around 20 years ago, she became highly skilled in placing mid and peripherally inserted central catheter (PICC) lines, nasojejunal (NJ) tubes and percutaneous endoscopic gastrostomies (PEGs). She developed a community ‘A Team’ of nurses to care for feeding tubes in primary care before becoming the UK’s first Nutrition Nurse Consultant. In addition to creating a team of nutrition nurses at RLUH, she was also a key figure in developing the Trust’s own ‘R Homecare’ company for HPN. Just to prove that she is superwoman, she has done all of this while living in the Peak District and commuting to Liverpool to work!

After a buzzing first day concluding with Satellite symposia sponsored by Abbott and Takeda, delegates took to the dance floor relieving ABBA Mania, bringing to life the flamboyance of the 70s and all the uplifting, dance-inducing tunes of Dancing Queen, Mamma Mia, Fernando and The Winner Takes It All to tribute band ABBA Planet.

Despite the late night, delegates rose early to support this year’s Breakfast Symposium, sponsored by Nutricia, to hear Mary Phillips and Fionna Page present on ‘The Importance of Individualised Nutritional Care.’

Chairs, Dr Jeremy Nightingale and Kirstine Farrer, report on the BIFA led symposium entitled Outpatient follow up of Home Parenteral Support (HPS). Dr Michael Glynn, Consultant Gastroenterologist and Hepatologist from Barts Health and Mia Small, Nurse Consultant Nutrition and Intestinal Failure from St Mark’s, spoke about the actions that a multidisciplinary team may take in an outpatient clinic. While attending to the underlying medical condition and medication, assessing symptoms, reviewing hydration and nutritional status (and goals), checking catheter care and any complications were important; they felt that other issues should be addressed, and these included challenging behaviour/compliance and lifestyle considerations. Dr Nick Thompson, Consultant Gastroenterologist, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, spoke about biochemical monitoring (referring to the BIFA position statement on the haematological and biochemical monitoring of adult patients receiving HPN) and about monitoring for osteoporosis. Dr Abdul Rahimi from Addenbrookes Hospital, Cambridge, presented the oral communication ‘Analysis of Regional Home Parenteral Support Patients and the Risk Factors Associated with Catheter Related Thrombosis.’ The symposium concluded with Dr Jeremy Woodward presenting a case ‘Abdominal Malignancy, Oedema and a Short Bowel’ with panellist, Carolyn Wheatley, Dr Phil Stevens, Sarah Zeraschi and Dr Sarah Kelly for audience participation.

The PENG Symposium Prehabilitation commenced with an oral communication from Linda Cantwell, Mersey Care NHS Foundation Trust entitled ‘Nutritional Prehabilitation in Head and Neck Cancer: A systematic review,’ which highlighted that there is a lack of nutritional prehabilitation research within this vulnerable cohort who potentially could have the most to gain from prehabilitation interventions. Ciara McSherry and David Curtin from North West Cancer Centre, Northern Ireland, presented their award winning prehabilitation programme. This quality improvement project was inspired by patient feedback as they described feeling that they were unprepared, and it was like ‘jumping from a plane’ as they started their treatment. This led to the development of a weekly radiotherapy guide and a more personalised plan for patients. They provided top tips on how to start a prehab program, the benefits to patients and the advantages of MDT working. Fraser Breed, Macmillan Project Manager/Advanced Dietitian, NHS Borders, discussed the development and implementation of Prehabilitation for Scotland, actively improving physical and mental wellbeing to prepare for what lies ahead a framework and resources to support patients to have access to prehabilitation in Scotland. This was commissioned by the Scottish government, created through extensive collaboration and with patient feedback. The symposium concluded with the presentation ‘The Challenges of Achieving Enhanced Recovery in Oesophago-Gastric Surgery’ in which Fiona Huddy, Specialist Oesophago-Gastric Dietitian, Royal Surrey NHS Foundation Trust, discussed the benefits of enhanced recovery after surgery (ERAS) in oesophago-gastric cancer patients. This involved reviewing every part of the surgical pathway and involved a trip to Seattle to observe their pathways and management. Here patients were encouraged to start eating, drinking, and mobilising earlier leading to a reduction in length of stay and surgical improvements including a reduction in anastomotic leaks. The ERAS protocol looked to optimise diabetic care, address anaemia, optimise nutrition and carbohydrate load pre-op. Fiona discussed when, what, and how much fluids and diet to start on was still debated and acknowledged that a lack of dietetic resource remained a barrier to the implementation of ERAS protocols nationally. The symposium created a lot of questions and discussion. We look forward to seeing how prehabilitation services develop and their impact on patient care and outcome across the four nations in the future.

The NNNG invited an expert panel of subject specialists to present and discuss Exploring NG Never Events – is NGT standardisation the answer in the modern NHS? in their led symposium chaired by Claire Campbell, Nutrition Nurse Lead, Guy’s and St Thomas’ NHS Foundation Trust. Nichola Crust, National Investigator, Healthcare Safety Investigation Branch (HSIB) outlined the reference event from 2018, creating a report for dissemination in 2020, with recommendations for developing and enhancing best practice. Not least, working far more effectively with NHS procurement and industry members to design and test new ways of obtaining and interpreting gastric aspirate for safe placement. Nichola brought a sincere reality to her presentation, having spent considerable time with the patient and family affected by this Never Event. Dr Damian Tolan, Consultant Radiologist from Leeds Teaching Hospitals NHS Trust followed with his presentation of small seeds make for great Oak Trees analogy when talking us through the quality improvement pathway for NGT siting – CXR confirmation.

Like many acute NHS trusts across the UK, he too experienced the frustrations and challenges faced with recurrent and out of hours requests. Collectively, an MDT pathway was created where targeted tubes are X-rayed with tube labelling and ward ownership for manipulating tube position into place, reducing time, replication, duplication, and ultimately creating a streamlined safe system that is understood and respected by all. Damian reminded us all of the importance for siting confirmation to keep a system both short and simple. This was a great take away, with a valuable reminder for the clinicians present. Representing the BAPEN Special Interest Group, NGSIG, Wendy Ling-Relph, Clinical Service Lead: Nutrition & Hydration, East Kent Hospitals University NHS Foundation Trust enabled the audience to evaluate the great work achieved to date, aligning best practice guidance from HSIB and LEEDs with that of its NGT Statement in 2020. Many aspects of service and role development were endorsed, inviting new ways of thinking around role, expertise and responsibility. The NNNG plan to take this valuable narrative and move forward with plans for standardising a national programme of education and training with competency assessment. We were lucky enough to profile the good work of Oscar Walton and his oral communication, ‘Cross-Sectional Study of Registered Dietitians’ Perspectives on Training to Position Nasogastric Tube,’ discussing his qualitative results from Dietitian’s who perform NGT practice. Here, the importance of advanced skills, effective patient care and MDT approach seen in the evolution and change of enteral tube feeding were reinforced. Discussion and debate followed providing a variety of themes. Dr Trevor Smith explained why the medical teams appear to be hands off with NGT care, unless asked to complete a CXR request or provide advice on a difficult to pass insertion. Trevor explained that the “see one, do one, teach one approach” remains to this day. Medical staff perceive this piece of tubing as one of simple insertion. A transparent and thought-provoking discussion followed. The inconsistencies surrounding gastric aspirates safe cut off points proved to be an area for improvement and development. Furthermore, the industry design of novel devices has made for a presence across the NHS and their benefits for assisting safe patient care. The NNNG are extremely grateful to Jo Wakeling, Committee Member and BAPEN representative for her excellent co-ordination and planning, pulling together a fantastic symposium and nutrition village.

BAPEN were delighted to have the Renal Nutrition Specialist Group of the British Dietetic Association (BDA) deliver the symposium Nutrition in Renal Medicine chaired by Joanna Pulman. The session started with a fascinating presentation ‘Acute Kidney Injury, Renal Replacement Therapy and Nutrition on the ICU’ from Dr Mark Devonald, Consultant Nephrologist, Liverpool University Hospitals NHS Foundation Trust, which explored the nutrient losses associated with renal replacement therapy in the intensive therapy unit (ITU), and posed the reviewed the evidence re nutritional losses in acute kidney injury (AKI) during continues renal replacement therapy. ‘Parenteral Nutrition in Kidney Disease’ presented by Bruno Mafrici, Lead Renal Dietitian, Nottingham University Hospitals NHS Trust, focused on parenteral nutrition in patients affected with kidney disease. The symposium concluded with the presentation ‘Kidney Stone Disease in Intestinal Failure’ presented by retired Consultant Nephrologist, Charlie Thomson, Trustee for Kidney Research UK who provided a practical overview of the management of kidney stones in patients with intestinal failure using diet and medications to help prevent stone formation and recurrence.

Dr Marcia McDougall, Fluid Lead for NHS Fife gave a fantastic keynote lecture, ‘Improving fluid management: something for everyone?’, clearly demonstrating why all healthcare professionals working in nutrition should take an interest in intravenous (IV) fluids. In 1999, National Confidential Enquiry into Patient Outcome and Death (NCEPOD) stated that 20% of people on IV fluids come to harm but despite high quality guidelines such as British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients (GIFTASUP) (2007) and NICE CG174 (2013) a problem still exists, not only from fluid, sodium and chloride overload but also inadequate fluid provision.

In order to improve IV fluid prescribing we need to standardise assessment and prescribing, improve and standardise education, reduce the numbers of different fluids in use, introduce good fluid balance charting and simplify our systems. Barriers to doing this include not having a Trust fluid policy, not having a Trust IV fluid lead, resistance from senior medical staff and poor fluid balance charting.

Marcia’s lecture was clearly well received by the audience giving them the following take home messages:

• Patients come to harm from excess or inadequate IV fluid provision
• Using guidelines, educating and standardising should prevent much of this harm
• Guidelines can be implemented safely – there is no evidence of a risk of hyponatraemia through using 0.18% NaCl in 4% glucose as maintenance fluid in adults
• Improving fluid prescription requires teamwork and time
• All health care professionals have a role to play in improving IV fluid use in the UK
• There is a new initiative to improve IV fluid use in the UK: @Turningthe_Tide
• Everyone should see Marcia’s paper in the BMJ on implementing NICE CG174 in Scotland, click here.

The BAPEN 2022 Annual Conference concluded with the final symposium Quandaries in Clinical Nutrition ably chaired by our esteemed Chair of the Programmes Committee, Pete Turner aimed to provide a light-hearted end to the conference with some important take home messages from the key contributors Alison Culkin, Priya Mistry, Sarah Jane Nelson, Marcia McDougall, Alastair Forbes, Alison Young, Trevor Smith, Simon Gabe and Pete Turner:

• There are pros and cons to using either compact or standard 1.5 kcal/ml oral nutritional supplements in patients with high output stoma so best approach is to use the ones they find most palatable and monitor the effect on stoma output
• There were considerable flaws in a publication that advised against flushing water into jejunal feeding tubes due risk of bowel necrosis based on a case study of 1 patient and animal study of 1 rat
• It is OK to flush 200 – 300 ml water 4-6 times into jejunal feeding tubes
• Patients often become oedematous because excess provision of 0.9% saline – often from IV medications such as antibiotics. 5% dextrose is usually a superior diluent for IV medicines in oedematous patients
• It is important to treat constipation in patients with leaking PEG tubes
• Some experts use expired or waste PN bags to fertilise their plants and the audience voted in favour of a PN gardener’s question time at next year’s conference!

 

The BAPEN Programmes would like to extend a special thanks to all those involved in organising symposia for this year’s BAPEN 2022 Conference with multi-disciplinary representation from each of the following organisations:

UK’s largest multidisciplinary Clinical Nutrition Conference

 

BAPEN Awards and Recognitions

Presented by Dr Trevor Smith, President and Dr Barry Jones, IAC Chair.

John Lennard-Jones Medal

The John Lennard Jones Medal is the highest accolade that the Association can bestow. This year there were two very worthy candidates who received this honour for their significant and consistent contribution to BAPEN over many years:

BAPEN also formally recognised previous recipients of the John Lennard-Jones Medal from 2020 and 2021 whose awards had previously been presented virtually during the webinar series.

2022 Roll of Honour were presented to…

• Kamini Gadhok MBE for the support given to BAPEN (via CAPA) on the subject of personal protective equipment (PPE)
• Kate Hall for her work on developing and launching the BAPEN values
• Sarah-Jane Nelson (Hughes) for her work on the Intestinal Failure Registry
• Christopher Mountford for his work on strengthening the financial governance and stability of BAPEN and his previous work on BAPEN Medical and BAPEN Medical Trainees Committee
• Andrew Rochford for his work on developing the updated BAPEN Strategy and his service to BAPEN Exec and BAPEN Medical of the years
• Heather Weaver for her support to HPN services nationally over a number of years and the national response to PN shortages
• Joe Kerin for support to the national response to PN shortages.

BAPEN’s Best Oral and Best Poster Awards were presented to…

Oral Communication Award was presented to Moira Dawson from University Hospitals of Leicester NHS Trust for her presentation entitled ‘Licensed Multi-chamber Parenteral Nutrition with administration of separate Intravenous Micronutrients in Critical Care’.

The Professor RG Clark Poster Prize was presented to lead author Dr Sally Wheelwright, for the poster entitled ‘Development and Pilot Testing of a Web-Based Decision Aid for People with Motor Neurone Disease Considering a Gastrostomy Tube (DiAMoND Study)’ by S. Wheelwright,¹ R. Maunsell,² S. Taylor,² N. Drinkwater,³ C. Erridge,⁴ C. Foster,² M. Hardcastle,⁵ A. Hogden,⁶ I. Lawson,² D. Lisiecka,⁷ C. McDermott,⁸ K. Morrison,⁹ C. Muir,² A. Recio-Saucedo² and S. White,⁸

^{1.University of Sussex, BN1 9RR, UK, 2.University of Southampton, SO17 1BJ, UK, 3.Motor Neurone Disease Association, NN3 6BJ, UK, 4.University Hospital Southampton NHS Foundation Trust, SO16 6YD, UK, 5.Rowans Hospice, PO7 5RU, UK, 6.Australian Institute of Health Service Management, Australia, 7.University of Limerick, Ireland, 8.University of Sheffield, S10 2HQ,UK, 9.Queen’s University Belfast, BT9 7BL, UK.}

Top Scoring Posters from 2021 were also recognised with an additional Poster Prize for 2021 being awarded to lead author Ella Terblanche for the poster entitled “Dietetic-led critical care nutrition interventions provided to critically ill patients with COVID-19 in a large London teaching hospital from March 2020 to April 2021” by E. Terblanche, J. Jackson, J. Wetherden, E. Russell and R. Lewis, St George’s University Hospitals NHS Foundation Trust, UK.

Powell-Tuck Prize

BAPEN Medical awarded two Powell-Tuck Prizes for the best abstract submitted by a doctor in training to:

Analysis of regional home parenteral support patients and the risk factors associated with catheter related thrombosis by E. Al Sulais, K. Edwards, A. Mahalingam, B Ellison, A Rahimi, P.S Patel and C.S. Rutter, Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ.

Standardised Survival and Excess Life Years Lost in patients with type 3 intestinal failure by M. Kopczynska,¹ C.L. Hvas,² P. Jepsen,² A. Teubner,¹ A. Abraham,¹ S. T Burden,^{1, 3} M. Taylor,¹ G. Carlson1 and S. Lal.^{1, 3}

^{1.Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Salford, United Kingdom 2.Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark, 3.University of Manchester, Manchester, United Kingdom}

Congratulations to our Award Winners!

 

 

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