Long‐term Outcomes for Infants With Intestinal Atresia Studied at Children's National Medical Center

Nusinovich, Yevgeniya; Revenis, Mary; Torres, Clarivet

doi:10.1097/mpg.0b013e318299fd9f

Cited by 35 publications

(18 citation statements)

References 15 publications

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“…This study uniquely investigated the epidemiology and healthcare burden of young children hospitalized with SBS at a national level in the United States. A major strength of this study is the novel use of a nationwide database, which minimizes the effects of regional and population biases to which previous single‐center and small multicenter studies were subject 4 , 5 . To compare and contrast the demographics and outcomes of patients with SBS, we selected an age‐matched and sex‐matched group of hospitalized children without SBS.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, few data derived from national registries are available regarding the epidemiology of SBS and health resource utilization related to this population in the United States. Previous studies were restricted to either single‐center or relatively small multicenter collaborations 4 , 5 . These data are thus unable to accurately portray the national disease burden and likely underrepresent the full disease impact carried by SBS in the pediatric population.…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology and Healthcare Resource Utilization Associated With Children With Short Bowel Syndrome in the United States

Pant

Sferra

Fischer

et al. 2015

J Parenter Enteral Nutr

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Epidemiology and Healthcare Resource Utilization Associated With Children With Short Bowel Syndrome in the United States

Pant

Sferra

Fischer

et al. 2015

J Parenter Enteral Nutr

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show abstract

“…The papers included [ 21 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ] were subdivided into two groups according to the treatment. Therefore, references [ 21 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ] included patients treated with PN alone or series in which less than 10% of patients were treated with combined PN and AGIR (Group 1). References [ 44 , 45 , 46 , 47 ,…”

Section: Methodsmentioning

confidence: 99%

To Wean or Not to Wean: The Role of Autologous Reconstructive Surgery in the Natural History of Pediatric Short Bowel Syndrome on Behalf of Italian Society for Gastroenterology, Hepatology and Nutrition (SIGENP)

et al. 2020

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Pediatric Short Bowel Syndrome (SBS) can require prolonged parenteral nutrition (PN). Over the years, SBS management has been implemented by autologous gastrointestinal reconstructive surgery (AGIR). The primary objective of the present review was to assess the effect of AGIR on weaning off PN. We also evaluated how AGIR impacts survival, the need for transplantation (Tx) and the development of liver disease (LD). We conducted a systematic literature search to identify studies published from January 1999 to the present and 947 patients were identified. PN alone was weakly associated with higher probability of weaning from PN (OR = 1.1, p = 0.03) and of surviving (OR = 1.05, p = 0.01). Adjusting for age, the probability of weaning off PN but of not surviving remained significantly associated with PN alone (OR = 1.08, p = 0.03). Finally, adjusting for age and primary diagnosis (gastroschisis), any association was lost. The prevalence of TX and LD did not differ by groups. In conclusion, in view of the low benefit in terms of intestinal adaptation and of the not negligible rate of complications (20%), a careful selection of candidates for AGIR should be required. Bowel dilation associated with failure of advancing EN and poor growth, should be criteria to refer for AGIR.

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“…A residual bowel length of only 15–40 cm has been associated with bowel adaptation, intestinal autonomy and PN weaning, but, most of the time with few information regarding the long-term growth [171819202122232425]. Numerous factors determine SBS prognosis: the underlying diagnosis, the type of segments preserved, the presence of the ileo-caecal valve (ICV) and the colon, a long-term stoma vs. a primary anastomosis, the number of surgical procedures, as well as the age of the patient at the time of surgery [171819202122232425]. Classification of SBS in 3 type is helpful for the understanding of different outcomes (Fig.…”

Section: Definition and Etiology Of The Sbsmentioning

confidence: 99%

Short Bowel Syndrome as the Leading Cause of Intestinal Failure in Early Life: Some Insights into the Management

Goulet

Nader

Pigneur

et al. 2019

Pediatr Gastroenterol Hepatol Nutr

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Intestinal failure (IF) is the critical reduction of the gut mass or its function below the minimum needed to absorb nutrients and fluids required for adequate growth in children. Severe IF requires parenteral nutrition (PN). Pediatric IF is most commonly due to congenital or neonatal intestinal diseases or malformations divided into 3 groups: 1) reduced intestinal length and consequently reduced absorptive surface, such as in short bowel syndrome (SBS) or extensive aganglionosis; 2) abnormal development of the intestinal mucosa such as congenital diseases of enterocyte development; 3) extensive motility dysfunction such as chronic intestinal pseudo-obstruction syndromes. The leading cause of IF in childhood is the SBS. In clinical practice the degree of IF may be indirectly measured by the level of PN required for normal or catch up growth. Other indicators such as serum citrulline have not proven to be highly reliable prognostic factors in children. The last decades have allowed the development of highly sophisticated nutrient solutions consisting of optimal combinations of macronutrients and micronutrients as well as guidelines, promoting PN as a safe and efficient feeding technique. However, IF that requires long-term PN may be associated with various complications including infections, growth failure, metabolic disorders, and bone disease. IF Associated Liver Disease may be a limiting factor. However, changes in the global management of IF pediatric patients, especially since the setup of intestinal rehabilitation centres did change the prognosis thus limiting “nutritional failure” which is considered as a major indication for intestinal transplantation (ITx) or combined liver-ITx.

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Long‐term Outcomes for Infants With Intestinal Atresia Studied at Children's National Medical Center

Abstract: These results compare favorably with those reported in earlier periods. With programs such as the IRP, patients with short bowel secondary to intestinal atresia can show improvement in liver function and nutritional parameters, and discontinue PN, avoiding the need for transplantation.

Cited by 35 publications

References 15 publications

Epidemiology and Healthcare Resource Utilization Associated With Children With Short Bowel Syndrome in the United States

Epidemiology and Healthcare Resource Utilization Associated With Children With Short Bowel Syndrome in the United States

To Wean or Not to Wean: The Role of Autologous Reconstructive Surgery in the Natural History of Pediatric Short Bowel Syndrome on Behalf of Italian Society for Gastroenterology, Hepatology and Nutrition (SIGENP)

Short Bowel Syndrome as the Leading Cause of Intestinal Failure in Early Life: Some Insights into the Management

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