The revision of the S3 guidelines for home enteral and parenteral nutrition by the German Society for Nutritional Medicine (DGEM) represents a significant advancement that our organization has embraced for years and will continue to champion. The updated guidelines not only affirm our established course but also underscore the critical importance of our work and our commitment to patient well-being.
Research and visionary thinking are the foundation of progress and expertise. In medicine, ongoing, in-depth investigations continually yield new insights, leading to the setting of new standards and the creation of innovative solutions. Such shifts are often initially met with skepticism and, at times, active resistance. However, we view the new guidelines as a clear validation of our previous initiatives, particularly in the field of nutritional medicine. Our efforts are aligned with these guidelines, and we remain steadfast in our commitment to advancing patient care.
For the first time, the commentary on Recommendation 118 highlights the technological advancements in multi-chamber bags, including Eurotubes: “[…] Multi-chamber bags with more than three compartments (Hepta-/Octa-/Nonatubes) are now available. These bags contain three chambers for macronutrients, along with up to six additional chambers for electrolytes, vitamins, trace elements, and other supplements. The infusion tubing system is pre-connected to the bag, as are 0.9% NaCl syringes for flushing. The benefits of these systems, such as reducing catheter-related infections and improving ease of use, are currently being evaluated in a multicenter study (Trial Comparing Parenteral Nutrition (PN) Using Eurotubes vs. 2/3-chamber Bags in Subjects With Advanced Cancer Requiring PN (PEKANNUSS) (ClinicalTrials.gov Identifier: NCT04105777).”
This reference highlights the technological progress represented by multi-chamber bags. It is anticipated that more companies will respond to this development, either by introducing innovative systems of their own or by adopting existing solutions. For patients, particularly those with oncological conditions or short bowel syndrome, such systems provide a safe and effective nutritional solution, allowing individualized care while mitigating the risk of infections from manual additions.
The S3 guideline establishes a new standard in nutritional medicine and paves the way for further innovations and improvements. This will benefit physicians, healthcare professionals, and patients alike, as a broader array of safe and user-friendly solutions becomes available.
Prof. Dr. Masin and his dedicated team within German foundation and MINST will continue to pursue this path of innovation and quality enhancement in nutritional medicine with unwavering determination. The revision reflects progress without favoring individual manufacturers and marks the beginning of an evolution that will invite other stakeholders to adopt and drive these standards forward.
