Long-term outcomes of pediatric intestinal failure.

Abstract:

:Management of pediatric intestinal failure has evolved in recent decades, with improved survival since the advent of specialized multidisciplinary intestinal failure centers. Though sepsis and intestinal failure associated liver disease still contribute to mortality, we now have growing data on the long-term outcomes for this population. While intestinal adaptation and parenteral nutrition weaning is most rapid during the first year on parenteral support, achievement of enteral autonomy is possible even after many years as energy and protein requirements decline dramatically with age. Intestinal transplant is an option for patients experiencing complications of long-term parenteral nutrition who are expected to have permanent intestinal failure, but outcomes are hindered by immunosuppression-related complications. Much of the available data comes from single center retrospective reports, with variable inclusion criteria, intestinal failure definitions, and follow-up durations; this limits the ability to analyze outcomes and identify best practices. As most children now survive long-term, the focus of management has shifted to the avoidance and management of comorbidities, support of normal growth and development, and optimization of quality of life for these medically and surgically complex patients.

journal_name

Semin Pediatr Surg

authors

Fullerton BS,Hong CR,Jaksic T

doi

10.1053/j.sempedsurg.2017.09.006

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

328-335

issue

5

eissn

1055-8586

issn

1532-9453

pii

S1055-8586(17)30098-7

journal_volume

26

pub_type

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