Neonatal Intestinal Failure and Transplantation

Pakarinen, Mikko P.; Morabito, Antonino

doi:10.1007/978-1-4471-4721-3_39

Cited by 1 publication

(2 citation statements)

References 95 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If deemed feasible based on the patient's clinical condition, underlying pathology, and anatomy, the enterostomy could be closed earlier than initially planned to avoid further clinical deterioration and adverse events as a consequence from the high‐out enterostomy 5,7 . However, restoring the enteral continuity is not always possible due to underlying pathology, such as total aganglionosis (from the colon) or paediatric intestinal pseudo‐obstruction syndrome requiring alternatives such as autologous intestinal reconstructive surgery or other reconstructive procedures 50–53 …”

Section: Discussionmentioning

confidence: 99%

“…5,7 However, restoring the enteral continuity is not always possible due to underlying pathology, such as total aganglionosis (from the colon) or paediatric intestinal pseudo-obstruction syndrome requiring alternatives such as autologous intestinal reconstructive surgery or other reconstructive procedures. [50][51][52][53] An observational multicenter study evaluated the value of autologous reconstructive surgery among eight children with (near) total intestinal aganglionosis, complicated by persistent high-output jejunostomy and failure to thrive. 54 Here, a high-output enterostomy was defined as daily enteric fluid loss of >20 mL/kg associated with poor weight gain and urine sodium level <10 mmol/L.…”

Section: Surgical Managementmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review on management of high‐output enterostomy in children: An urgent call for evidence

Stoop,

van Bodegraven,

ten Haaft

et al. 2023

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

Objectives/BackgroundHigh‐output stoma is one of the most common major morbidities in young children with an enterostomy that could lead to intestinal failure. Management of high‐output enterostomy in children is mostly based on personal experience. This systematic review aims to clarify the evidence‐based therapeutic approach of high‐output enterostomy in children.MethodsA systematic review was performed using Pubmed, Embase (Ovid), and Cochrane Library to identify studies published until March 20, 2023, following the 2020 Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline. The study population comprised children (i.e., age <18 years) with high‐output enterostomy (i.e., jejuno‐, ileo‐, and/or colostomy), regardless of underlying aetiology. Interventions comprised any (non)pharmacological and/or surgical treatment. Interventions were compared with each other, placebos, and/or no interventions. Primary outcome was reduction of enterostomy output. Secondary outcomes were morbidity, mortality, quality of life, associated healthcare costs, and adverse events.ResultsThe literature search identified 4278 original articles of which 366 were screened on full text, revealing that none of the articles met the inclusion criteria.ConclusionThis first systematic review on management of high‐output enterostomy in children revealed that any evidence on the primary and secondary outcomes is lacking. There is an urgent need for evidence on conservative treatment strategies including fluid restrictions, dietary advices, oral rehydration solution, chyme re‐infusion, and pharmacological and surgical treatments of high‐output enterostomy in children, aiming to reduce the risk for short‐ and long‐term complications. Till more evidence is available, a systematic and multidisciplinary step‐up approach is needed. Therefore, a therapeutic work‐up is proposed that could guide the care.

show abstract

Section: Discussionmentioning

confidence: 99%