Pediatric Intestinal Failure Review

Abstract

The term, ‘intestinal failure’, signifies the inability of the body to meet the digestive, absorptive and nutritive needs of the body. As such, these individuals require parenteral nutrition (PN) for survival. The subsequent nutritional, medical and surgical facets to the care are complex. Improved care has resulted in decreased need for intestinal transplantation. This review will examine the unique etiologies and management strategies in pediatric patients with intestinal failure.

A Comparison of Smoflipid® and Intralipid® in the Early Management of Infants with Intestinal Failure

“…Approximately 40-60% of infants on long term PN will develop some degree of liver injury in the form of cholestasis, with 15% progressing to irreversible liver failure [6,7]. The etiology is multifactorial and includes prematurity, duration and dose of PN, lack of enteral feeding, and infectious episodes [8,9]. It has been recognized that an important contributing factor to IFALD is the type of intravenous lipid emulsion (ILE) administered, potentially due to the metabolic, inflammatory, and immunosuppressive effects of certain fatty acid components [10].…”

Citrulline, Biomarker of Enterocyte Functional Mass and Dietary Supplement. Metabolism, Transport, and Current Evidence for Clinical Use

“…The most common etiology is short bowel syndrome (SBS), which describes a reduction in anatomical and functional bowel length [ 64 , 65 , 66 , 67 ]. Several diseases of the gastrointestinal tract, including necrotizing enterocolitis (NEC), intestinal atresia [ 68 ], midgut volvulus, and long-segment Hirschsprungs’ disease in children, as well as mesenteric ischemia, Crohn’s disease, and irradiation in adults [ 65 ], may lead to extensive damage and/or intestinal resections ending in SBS [ 69 ]. Patients with chronic intestinal failure can be dependent on long-term parenteral nutrition with its inherent morbidity and mortality, including (repeated) catheter-associated sepsis, cirrhosis, and liver failure [ 69 ].…”

“…Several diseases of the gastrointestinal tract, including necrotizing enterocolitis (NEC), intestinal atresia [ 68 ], midgut volvulus, and long-segment Hirschsprungs’ disease in children, as well as mesenteric ischemia, Crohn’s disease, and irradiation in adults [ 65 ], may lead to extensive damage and/or intestinal resections ending in SBS [ 69 ]. Patients with chronic intestinal failure can be dependent on long-term parenteral nutrition with its inherent morbidity and mortality, including (repeated) catheter-associated sepsis, cirrhosis, and liver failure [ 69 ]. While many factors seem to play a role, the length of the remnant intestine and the type of digestive anastomosis reflects a major determinant of patient survival and nutritional prognosis [ 67 , 70 , 71 ].…”

Intensive care and the surgical treatment children with the short bowel syndrome (review)

“…У пацієнтів із СКК ці середники призначаються за 30 хв до годування та перед сном [96]. Ще одним із чинників виникнення діареї у дітей із СКК є мальабсорбція жовчних кислот, які всмоктуються у дистальних відділах тонкої кишки [59]. Цю діарею можна лікувати середниками, які зв'язують жовчні кислоти (холестерамін).…”