دورية أكاديمية
Parenteral support and micronutrient deficiencies in children with short bowel syndrome: A comprehensive retrospective study.
| العنوان: | Parenteral support and micronutrient deficiencies in children with short bowel syndrome: A comprehensive retrospective study. |
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| المؤلفون: | Chatzidaki V; Department of Pediatric Gastroenterology, Royal Manchester Children's Hospital, NHS Foundation Trust, UK. Electronic address: v.chatzidaki@nhs.net., Wood R; Department of Pediatric Gastroenterology, Royal Manchester Children's Hospital, NHS Foundation Trust, UK., Alegakis A; Laboratory of Toxicology, University of Crete, Greece., Lawson M; Department of Pediatric Gastroenterology, Royal Manchester Children's Hospital, NHS Foundation Trust, UK., Fagbemi A; Department of Pediatric Gastroenterology, Royal Manchester Children's Hospital, NHS Foundation Trust, UK. |
| المصدر: | Clinical nutrition ESPEN [Clin Nutr ESPEN] 2023 Dec; Vol. 58, pp. 270-276. Date of Electronic Publication: 2023 Oct 14. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101654592 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2405-4577 (Electronic) Linking ISSN: 24054577 NLM ISO Abbreviation: Clin Nutr ESPEN Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [Oxford] : Elsevier Ltd., [2015]- |
| مواضيع طبية MeSH: | Intestinal Failure*/etiology , Intestinal Failure*/therapy , Micronutrients*/administration & dosage , Micronutrients*/deficiency , Micronutrients*/therapeutic use , Short Bowel Syndrome*/etiology , Short Bowel Syndrome*/therapy , Trace Elements*/administration & dosage , Trace Elements*/deficiency , Trace Elements*/therapeutic use , Parenteral Nutrition*/methods, Child ; Humans ; Infant, Newborn ; Intestinal Diseases/etiology ; Intestinal Diseases/therapy ; Intestinal Volvulus/complications ; Retrospective Studies |
| مستخلص: | Background & Aims: Short bowel syndrome (SBS) is the leading cause of chronic intestinal failure. The duration of parenteral support (PS) and the long-term micronutrient needs in children with SBS vary, based on their clinical and anatomical characteristics. Our study aimed to review the clinical course and identify high risk patient groups for prolonged PS and long-term micronutrient supplementation. Methods: A retrospective review was conducted on electronic medical records of children with SBS and chronic intestinal failure who were enrolled in the multidisciplinary intestinal rehabilitation program at Manchester Children's Hospital, UK. Children were included in the review if they required PN for more than 60 days out of 74 consecutive days and had at least 3 years of follow-up. Statistical analysis was performed using IBM SPSS Statistics 24.0. Results: 40 children with SBS achieved enteral autonomy (EA) and 14 remained dependent on PS after 36 months of follow up. Necrotizing enterocolitis was the most common cause for intestinal resection (38.9%) followed by gastroschisis (22.2%), malrotation with volvulus (20.4%), segmental volvulus (9.3%) and long segment Hirschsprung disease (1.9%). Those who achieved EA had significantly longer intestinal length 27.5% (15.0-39.3) than those who remained on PS 6.0% (1.5-12.5) (p < 0.001). Type I SBS was only found in the PS cohort. Median PN dependence was 10.82 months [IQR 5.73-20.78]. Congenital diagnosis was associated with longer PN dependence (21.0 ± 20.0) than acquired (8.7 ± 7.8 months), (p = 0.02). The need for micronutrient supplementation was assessed after the transition to EA; 87.5% children had at least one micronutrient depletion, most commonly Vitamin D (64.1%), followed by iron (48.7%), Vitamin B12 (34.2%), and vitamin E (28.6%). Iron deficiency and vitamin A depletion were correlated with longer PS after multivariate analysis (OR: 1.103, 1.006-1.210, p = 0.037 and OR: 1.048, 0.998-1.102, p = 0.062 respectively). Conclusion: In our cohort, small bowel length was the main predictor for EA. Children on longer PS, had more often a congenital cause of resection and were at risk for micronutrient deficiencies in EA. (Copyright © 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Micronutrients; Parenteral nutrition; Short bowel syndrome |
| المشرفين على المادة: | 0 (Micronutrients) 0 (Trace Elements) |
| تواريخ الأحداث: | Date Created: 20231206 Date Completed: 20240122 Latest Revision: 20240411 |
| رمز التحديث: | 20240412 |
| DOI: | 10.1016/j.clnesp.2023.10.008 |
| PMID: | 38057017 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 2405-4577 |
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| DOI: | 10.1016/j.clnesp.2023.10.008 |