Medical management of motility disorders in patients with intestinal failure: a focus on necrotizing enterocolitis, gastroschisis, and intestinal atresia

Dicken, Bryan; Sergi, Consolato; Rescorla, Frederick J.; Breckler, Francine D.; Sigalet, David L.

doi:10.1016/j.jpedsurg.2011.04.002

Cited by 65 publications

(45 citation statements)

References 87 publications

(186 reference statements)

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“…Previous reports have shown the benefits of a multi-disciplinary team approach in improving the outcomes in intestinal failure and PNALD (24)(25)(26). The multi-disciplinary approach in our hospital includes a core group of neonatologists, pediatric gastroenterologists, surgeons, dietitians, nurses, social workers, and case managers.…”

Section: Discussionmentioning

confidence: 99%

Fish Oil–Based Lipid Emulsions in the Treatment of Parenteral Nutrition-Associated Liver Disease: An Ongoing Positive Experience

Premkumar

Carter

Hawthorne

et al. 2014

Advances in Nutrition

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We previously reported the beneficial effect of fish oil-based lipid emulsions (FOLEs) as monotherapy in the treatment of parenteral nutritionassociated liver disease (PNALD). In this report, we share our ongoing experience at Texas Children's Hospital, Houston, Texas in the use of FOLE in treatment of PNALD as presented at the 2013 Experimental Biology meeting. We describe the findings of a single center, prospective, observational study of infants <6 mo of age with PNALD who received parenteral FOLE as monotherapy. A total of 97 infants received FOLE under the compassionate-use protocol for the treatment of PNALD. Eighty-three (86%) survived with resolution of cholestasis and 14 (14%) died. The median conjugated bilirubin (CB) concentration at the initiation of FOLE therapy was 4.8 mg/dL (range 2.1-26). The median time to resolution of cholestasis was 40 d (range 3-158). Compared with infants with mild cholestasis (CB of 2.1-5 mg/dL at the initiation of FOLE), nonsurvivors were significantly more premature and took longer to resolve their cholestasis. Gestational age at birth correlated inversely with CB at the beginning of FOLE and peak CB. Infants with an initial CB >10 mg/dL had a higher mortality rate than infants with an initial CB <5 mg/dL (35% vs. 6%; P < 0.05). Our experience with the use of FOLE in PNALD continues to be encouraging. Prematurity continues to be a major determinant in mortality and severity of cholestasis. This calls for further controlled studies designed to optimize dose and timing of intervention in the use of FOLE in neonates. Adv. Nutr. 5: 65-70, 2014.

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Section: Discussionmentioning

confidence: 99%

Fish Oil–Based Lipid Emulsions in the Treatment of Parenteral Nutrition-Associated Liver Disease: An Ongoing Positive Experience

Premkumar

Carter

Hawthorne

et al. 2014

Advances in Nutrition

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“…Delayed maturation of the intestinal pacemaker and smooth muscle cells has been demonstrated in a rat model of gastroschisis [45], which may explain the delayed onset of peristalsis in these patients. However, its etiology has not yet been completely unveiled, and there is no safe and effective treatment for the intestinal dysmotility other than awaiting spontaneous resolution [2,3,46].…”

Section: Discussionmentioning

confidence: 99%

“…However, there is little documentation in the literature to support their use. Commonly utilized prokinetic agents include erythromycin, metoclopramide, domperidone and cisapride [2]. A randomized controlled trial of erythromycin versus placebo showed that enterally administered erythromycin did not improve the time required to achieve full enteral feeding compared with placebo [3].…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of Dai-kenchu-to in postoperative infants with gastroschisis

Otake¹,

Uchida²,

Koike³

et al. 2012

OJPed

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Purpose: Intestinal dysfunction is a major problem after gastroschisis repair, and causes poor oral intake and poor body weight gain in infants with gastroschisis. Dai-kenchu-to (DKT) is often used in the treatment of gastrointestinal dysfunction in Japan. The purpose of this study was to analyze the effect of DKT on infants with uncomplicated gastroschisis. Methods: In this retrospective cohort study from 1991 to 2009, we assessed 16 infants with uncomplicated gastroschisis. Eight infants received 0.3 g/kg/day of DKT for 12 months (group 1) and 8 infants did not receive DKT (group 2). We analyzed their body weight as an indicator of the effect of DKT. Results: There were no significant differences in the background characteristics. The body weight of group 1 was significantly increased at the ages of 9 months (p = 0.0348) and 12 months (p = 0.0097), compared with group 2. Multivariate analyses revealed that only DKT administration had a significant impact on body weight gain at the ages of 9 months (p = 0.0201) and 12 months (p = 0.0111). No side effects related to DKT were reported. Conclusion: DKT administration might worksafely and effectively for improvingthe body weight gain in infants with uncomplicated gastroschisis.

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“…Current treatment of NEC includes cessation of enteral feeding, antibiotic therapy, and surgical removal of the necrotic intestine, but all of these treatments are accompanied by devastating long-term complications. 4–6 …”

Section: Introductionmentioning

confidence: 99%

Enzymatic and Chemoenzymatic Syntheses of Disialyl Glycans and Their Necrotizing Enterocolitis Preventing Effects

Yan

Autran

et al. 2017

J. Org. Chem.

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Necrotizing enterocolitis (NEC) is one of the most common and devastating intestinal disorders in preterm infants. Therapies to meet the clinical needs for this special and highly vulnerable population are extremely limited. A specific human milk oligosaccharide (HMO), disialyllacto-N-tetraose (DSLNT), was shown to contribute to the beneficial effects of breastfeeding as it prevented NEC in a neonatal rat model and was associated with lower NEC risk in a human clinical cohort study. Herein, gram-scale synthesis of two DSLNT analogs previously shown to have NEC preventing effect is described. In addition, four novel disialyl glycans have been designed and synthesized by enzymatic or chemoenzymatic methods. Noticeably, two disialyl tetraoses have been produced by enzymatic sialylation of chemically synthesized thioethyl β-disaccharides followed by removal of the thioethyl aglycon. Dose-dependent and single-dose comparison studies showed varying NEC-preventing effects of the disialyl glycans in neonatal rats. This study helps to refine the structure requirement of the NEC-preventing effect of disialyl glycans and provides important dose-dependent information for using DSLNT analogs as potential therapeutics for NEC prevention in preterm infants.

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Medical management of motility disorders in patients with intestinal failure: a focus on necrotizing enterocolitis, gastroschisis, and intestinal atresia

Cited by 65 publications

References 87 publications

Fish Oil–Based Lipid Emulsions in the Treatment of Parenteral Nutrition-Associated Liver Disease: An Ongoing Positive Experience

Fish Oil–Based Lipid Emulsions in the Treatment of Parenteral Nutrition-Associated Liver Disease: An Ongoing Positive Experience

Safety and efficacy of Dai-kenchu-to in postoperative infants with gastroschisis

Enzymatic and Chemoenzymatic Syntheses of Disialyl Glycans and Their Necrotizing Enterocolitis Preventing Effects

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