Long-term outcomes of pediatric intestinal failure
Autor: | Brenna S. Fullerton, Tom Jaksic, Charles R. Hong |
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Rok vydání: | 2017 |
Předmět: |
Short Bowel Syndrome
Parenteral Nutrition Transition to Adult Care medicine.medical_specialty Population Single Center Enteral administration Sepsis 03 medical and health sciences Liver disease Enteral Nutrition 0302 clinical medicine Quality of life 030225 pediatrics Humans Medicine Child Intensive care medicine education education.field_of_study business.industry medicine.disease Short bowel syndrome Intestines Intestinal Diseases Treatment Outcome Parenteral nutrition Pediatrics Perinatology and Child Health Quality of Life 030211 gastroenterology & hepatology Surgery business |
Zdroj: | Seminars in Pediatric Surgery. 26:328-335 |
ISSN: | 1055-8586 |
Popis: | 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. |
Databáze: | OpenAIRE |
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