Early enteral feeding after pediatric abdominal surgery: A systematic review of the literature
| Autor: | Susan Adams, Douglas Greer, Jonathan Karpelowsky, Yasiru G. Karunaratne |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty Adolescent medicine.medical_treatment Pyloromyotomy Enteral administration law.invention Enteral Nutrition Postoperative Complications Randomized controlled trial law Abdomen medicine Humans Child Digestive System Surgical Procedures business.industry Infant Newborn Infant General Medicine Evidence-based medicine Length of Stay Gastrostomy Parenteral nutrition Child Preschool Pediatrics Perinatology and Child Health Surgery business Abdominal surgery Cohort study |
| Zdroj: | Journal of Pediatric Surgery. 55:1180-1187 |
| ISSN: | 0022-3468 |
| Popis: | Introduction Traditionally enteral nutrition has been delayed following abdominal surgery in children, to prevent complications. However, recent evidence in the adult literature refutes the supposed benefits of fasting and suggests decreased complications with early enteral nutrition (EEN). This review aimed to compile the evidence for EEN in children in this setting. Methods Databases Pubmed, EmBase, Medline and reference lists were searched for articles containing relevant search terms according to PRISMA guidelines. First and second authors reviewed abstracts. Studies containing patients less than 18 years undergoing abdominal surgery, with feeding initiated earlier than standard practice, were included. Studies including pyloromyotomy were excluded. Primary outcome was length of stay (LOS). Secondary outcomes included time to full enteral nutrition, time to stool and postoperative complications. Results Fourteen articles met inclusion criteria — five on neonatal abdominal surgery, three on gastrostomy formation and six on intestinal anastomoses. There were three randomized control trials (RCTs), five cohort studies, four historical control trials, one nonrandomized trial and one case series. Nine studies showed a decreased LOS with EEN. Most studies which reported time to full enteral nutrition showed improvement with EEN; however, time to stool was similar in most studies. Postoperative complications were either decreased or not statistically different in EEN groups in all studies. Conclusion Studies to date in a limited number of procedures suggest EEN appears safe and effective in children undergoing abdominal surgery. Although robust evidence is lacking, there are clear benefits in LOS and time to full feeds, and no increase in complications. Level of evidence IV |
| Databáze: | OpenAIRE |
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