Document Detail


10-year review of pediatric intestinal failure: clinical factors associated with outcome.
MedLine Citation:
PMID:  18682597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Prediction of outcomes in pediatric intestinal failure is challenging but essential to guide intestinal rehabilitation and transplantation decisions. This review of intestinal failure patients spanning 10 years examines clinical details in relation to outcome to identify factors that may refine predictive accuracy. A search was conducted to identify all children with intestinal failure managed at Stollery Children's Hospital between January 1994 and December 2003. They were divided into 3 groups: early death occurring <or=30 days of age, parenteral nutrition dependence for 30-100 days, and parenteral nutrition dependence for >100 days. The long-term group was divided according to outcome: death or adaptation. Demographics, diagnosis, nutrition requirements, laboratory parameters, and clinical data were recorded. Groups were compared to identify factors associated with outcome. Necrotizing enterocolitis, gastroschisis, and intestinal atresias were the most common causes for intestinal failure; outcome was not related to diagnosis. Although withdrawal of therapy was common in the early death group, most babies had one or more additional significant comorbidity. Among the 29 babies requiring parenteral nutrition for >100 days with known outcomes, 12 died, 16 adapted fully, and 1 received a multivisceral transplant. Intestinal length >40 cm was associated with a significantly increased risk of mortality (P< .001). Abnormal laboratory values (bilirubin, aspartate aminotransferase, alanine aminotransferase, albumin, and platelet count) after 5 months of age were also significantly different between groups. This data, together with data from previous reviews, should be used to investigate potential predictive factors in prospective studies, particularly in the context of expert multidisciplinary care.
Authors:
Linda Casey; Karr-Hong Lee; Rhonda Rosychuk; Justine Turner; Hien Q Huynh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition     Volume:  23     ISSN:  0884-5336     ISO Abbreviation:  Nutr Clin Pract     Publication Date:    2008 Aug-Sep
Date Detail:
Created Date:  2008-08-06     Completed Date:  2009-01-06     Revised Date:  2010-04-29    
Medline Journal Info:
Nlm Unique ID:  8606733     Medline TA:  Nutr Clin Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  436-42     Citation Subset:  IM; N    
Affiliation:
Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological
Adolescent
Birth Weight
Child
Child, Preschool
Female
Follow-Up Studies
Gestational Age
Humans
Infant
Infant, Newborn
Intestinal Diseases / diet therapy*,  mortality,  rehabilitation
Male
Parenteral Nutrition / mortality,  statistics & numerical data*
Retrospective Studies
Risk Factors
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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