Long-term outcomes for infants with intestinal atresia studied at Children's National Medical Center
| Autor: | Mary E. Revenis, Yevgeniya Nusinovich, Clarivet Torres |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Short Bowel Syndrome congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Parenteral Nutrition MEDLINE Intestinal Atresia Postoperative Complications Intestine Small otorhinolaryngologic diseases Long term outcomes medicine Prevalence Humans Hyperbilirubinemia Retrospective Studies Patient discharge Cholestasis business.industry General surgery Intestinal atresia Gastroenterology Infant Newborn Retrospective cohort study Bilirubin medicine.disease Hospitals Patient Discharge Parenteral nutrition Pediatrics Perinatology and Child Health Female Parenteral Nutrition Total business |
| Zdroj: | Journal of pediatric gastroenterology and nutrition. 57(3) |
| ISSN: | 1536-4801 |
| Popis: | Intestinal atresia is a common cause of intestinal obstruction in neonates. The predominant cause of late complications in these children is prolonged dependence on parenteral nutrition (PN). Our aims were to analyze the outcomes for patients with intestinal atresia at our institution, and to see how these changed with the implementation of an intestinal rehabilitation program (IRP).This is a retrospective cohort study. The patient population is all children with intestinal atresias (118 patients) treated at our institution from July 2000 to June 2010, 20 of whom became PN dependent.Survival to hospital discharge was 95% for all patients, and 100% for those who had isolated atresia. Twenty of 118 patients (17%) were PN dependent beyond initial hospital discharge. At discharge, their median intestinal length was 22.5 cm, and they required PN for a mean of 88.5% of energy needs. Of these 20 patients, 2 died, 2 received transplants, and 2 transferred away for transplantation. The remaining 14 joined the IRP. Their mean energy requirement from PN is presently 10%, down from 87% at IRP enrollment, and 10 patients fully weaned off PN. Eleven of the 14 children had hyperbilirubinemia, with mean direct bilirubin of 7.5 mg/dL. All resolved their cholestasis during an average of 12 weeks.These results compare favorably with those reported in earlier periods. With programs such as the IRP, patients with short bowel secondary to intestinal atresia can show improvement in liver function and nutritional parameters, and discontinue PN, avoiding the need for transplantation. |
| Databáze: | OpenAIRE |
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