A Review of Enteral Strategies in Infant Short Bowel Syndrome: Evidence-based or NICU Culture?

Miller, Malki; Burjonrappa, Sathyaprasad

doi:10.1016/j.jpedsurg.2013.01.023

Cited by 28 publications

(15 citation statements)

References 134 publications

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“…The evidence base for medical and nutritional intervention in pediatric SBS is limited and of poor quality (Barclay et al 2011). Several controversies about nutritional management in children remain, because most practices are more "experience based" than "evidence based" Miller and Burjonrappa 2013). The creation of networks of centres of excellence for intestinal rehabilitation is a promising initiative for optimizing management and promoting patient-oriented applied research.…”

Section: Resultsmentioning

confidence: 99%

Short bowel syndrome in infants: the critical role of luminal nutrients in a management program

Roy

Groleau

Bouthillier

et al. 2014

Appl. Physiol. Nutr. Metab.

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Short bowel syndrome develops when the remnant mass of functioning enterocytes following massive resections cannot support growth or maintain fluid-electrolyte balance and requires parenteral nutrition. Resection itself stimulates the intestine's inherent ability to adapt morphologically and functionally. The capacity to change is very much related to the high turnover rate of enterocytes and is mediated by several signals; these signals are mediated in large part by enteral nutrition. Early initiation of enteral feeding, close clinical monitoring, and ongoing assessment of intestinal adaptation are key to the prevention of irreversible intestinal failure. The length of the functional small bowel remnant is the most important variable affecting outcome. The major objective of intestinal rehabilitation programs is to achieve early oral nutritional autonomy while maintaining normal growth and nutrition status and minimizing total parenteral nutrition related comorbidities such as chronic progressive liver disease. Remarkable progress has been made in terms of survivability and quality of life, especially in the context of coordinated multidisciplinary programs, but much work remains to be done.

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Section: Resultsmentioning

confidence: 99%

Short bowel syndrome in infants: the critical role of luminal nutrients in a management program

Roy

Groleau

Bouthillier

et al. 2014

Appl. Physiol. Nutr. Metab.

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“…Even if in most SBS infants, feeding strategies alone are not sufficient to overcome the constraints of a reduced intestinal surface area to meet nutrient requirements, elemental or semi-elemental formulae, and continuous drip feeding are described to be successful [30,31,32]. The composition of main formulae available in Italy is showed in Table 2.…”

Section: Fats In Infant Formulae Intended For Medical Condition (Amentioning

confidence: 99%

“…The addition of fats, in the form of either LCTs or MCTs, to formulae is more frequent than that of carbohydrates or proteins since effects on formula osmolality are minimal [31]. …”

Section: Fats In Infant Formulae Intended For Medical Condition (Amentioning

confidence: 99%

“…N-3 LC-PUFAs were also shown to have anti-inflammatory effects while improving splanchnic circulation and cholestasis in these patients [8]. In a randomized controlled trial, using an n-6 based source of LCTs with an n-3 supplement to maintain appropriate ratios, preliminary results show positive effects on growth, feeding tolerance, and fecal consistency [31]. …”

Section: Fats In Infant Formulae Intended For Medical Condition (Amentioning

confidence: 99%

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The Role of Lipids in Human Milk and Infant Formulae

et al. 2018

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The quantity and quality of dietary lipids in infant formulae have a significant impact on health outcomes, especially when fat storing and/or absorption are limited (e.g., preterm birth and short bowel disease) or when fat byproducts may help to prevent some pathologies (e.g., atopy). The lipid composition of infant formulae varies according to the different fat sources used, and the potential biological effects are related to the variety of saturated and unsaturated fatty acids. For example, since lipids are the main source of energy when the normal absorptive capacity of the digestive tract is compromised, medium-chain saturated fatty acids might cover this requirement. Instead, ruminant-derived trans fatty acids and metabolites of n-3 long-chain polyunsaturated fatty acids with their anti-inflammatory properties can modulate immune function. Furthermore, dietary fats may influence the nutrient profile of formulae, improving the acceptance of these products and the compliance with dietary schedules.

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“…The advantages and disadvantages of the different animal models have been reviewed in detail [32 && ]. Controlled studies in humans are spares and have mostly been performed in neonates [33]. The significant gap between animal and clinical studies is mostly related to difficulties to establish and sustain a controlled diet and to define and measure meaningful outcomes in patients.…”

Section: Key Pointsmentioning

confidence: 99%