Document Detail


Clinical improvement following home parenteral nutrition in pediatric patients with intestinal failure.
MedLine Citation:
PMID:  16638650     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: Home parenteral nutrition (HPN) is being increasingly used to treat children with intestinal failure. This study evaluated the long-term growth, outcome and complications in Taiwanese pediatric patients with intestinal failure who were treated with HPN. METHODS: This retrospective study included 27 consecutive pediatric patients with intestinal failure who received long-term HPN between 1987 and 2002. These patients were categorized into two groups according to whether they had short bowel syndrome or a bowel motility disorder. Growth, prognosis and complications, including cholestasis, hypoglycemia, hyperglycemia and infections were compared between the two groups. RESULTS: The median age of starting HPN was significantly younger in patients with short bowel syndrome (5 months) than in patients with motility disorders (1.9 years). The median duration of HPN treatment in the overall group was 13.5 months (range, 2.1-113.1 months); weight and height increased 1.7 +/- 2.3 and 1.0 +/- 1.6 in z score, respectively. The most common complications were cholestatic liver disease (52%), hypoglycemia (15%) and hyperglycemia (33%). All patients maintained stable serum glucose levels at follow-up. Cholestatic liver disease developed after 2.3 +/- 2.0 months of total HPN in 13 patients, which subsided after 9.7 +/- 6.9 months in 11 patients, while two patients died. The mean incidence of central venous infection was 3.0 +/- 3.3 per 1000 HPN days. The most common pathogens were Staphylococcus spp. (50%) and Candida spp. (30.6%). CONCLUSION: HPN treatment can successfully provide a bridge to enteral nutrition in pediatric patients with intestinal failure. The metabolic disturbances and cholestasis are usually transient, but infection control is important throughout the period of HPN treatment.
Authors:
Yi-Ching Tung; Yen-Hsuan Ni; Hong-Shiee Lai; Der-Yirng Hsieh; Mei-Hwei Chang
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Formosan Medical Association = Taiwan yi zhi     Volume:  105     ISSN:  0929-6646     ISO Abbreviation:  J. Formos. Med. Assoc.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-26     Completed Date:  2006-06-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9214933     Medline TA:  J Formos Med Assoc     Country:  China    
Other Details:
Languages:  eng     Pagination:  399-403     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Colonic Diseases, Functional / therapy*
Female
Gastrointestinal Motility*
Humans
Infant
Male
Parenteral Nutrition, Home* / adverse effects
Retrospective Studies
Short Bowel Syndrome / therapy*
Treatment Outcome

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


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