Innovative parenteral and enteral nutrition therapy for intestinal failure.
Semin Pediatr Surg
; 19(1): 27-34, 2010 Feb.
Article
em En
| MEDLINE
| ID: mdl-20123271
ABSTRACT
Children with intestinal failure (IF) suffer from insufficient intestinal length or function, making them dependent on parenteral nutrition (PN) for growth and survival. PN and its components are associated with many complications ranging from simple electrolyte abnormalities to life-threatening PN-associated liver disease, which is also called intestinal failure-associated liver disease (IFALD). From a nutrition perspective, the ultimate goal is to provide adequate caloric requirements and make the transition from PN to full enteral nutrition (EN) successful. Upon review of the literature, we have summarized the most effective and innovative PN and EN therapies for this patient population. Antibiotic-coated catheters and antibiotic or ethanol locks can be implemented, as they appear effective in reducing catheter-related infection and thus further reduce the risk of IFALD. Lipid emulsions should be given judiciously. The use of an omega-3 fatty acid-based formulation should be considered in patients who develop IFALD. Trophic feeding is important for intestinal adaptation, and EN should be initiated early to help wean patients from PN. Long-term management of children with IF continues to be an emerging field. We have entered uncharted territory as more children survive complications of IF and IFALD. Careful monitoring and individualized management to ensure maintenance of growth while avoiding complications are the keys to successful patient outcomes.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Nutrição Enteral
/
Nutrição Parenteral
/
Recuperação de Função Fisiológica
/
Síndromes de Malabsorção
Limite:
Child
/
Humans
Idioma:
En
Revista:
Semin Pediatr Surg
Assunto da revista:
PEDIATRIA
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Estados Unidos