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Predicting time to full enteral nutrition in children after significant bowel resection.
J Pediatr Surg. 2017 May; 52(5):764-767.JP

Abstract

PURPOSE

Parenteral nutrition (PN) contributes to considerable morbidity in children after significant bowel resection. This study evaluates the utility of clinical variables in predicting time to independence from PN.

METHODS

After IRB approval, a retrospective review (1999-2012) of 71 children who were on PN for >6weeks after intestinal resection and successfully weaned was performed. Clinical characteristics were evaluated to determine the relationship to time to full enteral nutrition. P-values<0.05 were significant.

RESULTS

Most children had necrotizing enterocolitis (56%), intestinal atresia (20%), or gastroschisis (11%) with a median small bowel length of 55cm (IQR, 35-92cm). The duration of PN was independent of the etiology of intestinal loss, presence of the ileocecal valve or colon, or location of anastomosis, but was strongly associated with small bowel length (<0.01) and percent of expected small bowel based on gestational age (GA) (median 50%, <0.01). In general, children who had 25-50% of their small bowel were dependent on PN for at least 2years compared to approximately 1year for those with 51-75%.

CONCLUSION

The duration of PN dependence in children after major bowel resection is best predicted by remaining small bowel length and can be estimated using a linear regression model.

LEVEL OF EVIDENCE

2b.

Authors+Show Affiliations

Department of Surgery, Baylor University Medical Center, Dallas, TX, USA.Office of the Chief Quality Officer, Baylor Scott and White Health, Dallas, TX, USA.Office of the Chief Quality Officer, Baylor Scott and White Health, Dallas, TX, USA.Division of Pediatric Gastroenterology, University of Texas Southwestern/Children's Health, Dallas, TX, USA.Division of Pediatric Gastroenterology, University of Texas Southwestern/Children's Health, Dallas, TX, USA.Division of Pediatric Surgery, University of Texas Southwestern/Children's Health, Dallas, TX, USA. Electronic address: hannah.piper@childrens.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28168985

Citation

Gonzalez-Hernandez, Jessica, et al. "Predicting Time to Full Enteral Nutrition in Children After Significant Bowel Resection." Journal of Pediatric Surgery, vol. 52, no. 5, 2017, pp. 764-767.
Gonzalez-Hernandez J, Prajapati P, Ogola G, et al. Predicting time to full enteral nutrition in children after significant bowel resection. J Pediatr Surg. 2017;52(5):764-767.
Gonzalez-Hernandez, J., Prajapati, P., Ogola, G., Channabasappa, N., Drews, B., & Piper, H. G. (2017). Predicting time to full enteral nutrition in children after significant bowel resection. Journal of Pediatric Surgery, 52(5), 764-767. https://doi.org/10.1016/j.jpedsurg.2017.01.038
Gonzalez-Hernandez J, et al. Predicting Time to Full Enteral Nutrition in Children After Significant Bowel Resection. J Pediatr Surg. 2017;52(5):764-767. PubMed PMID: 28168985.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predicting time to full enteral nutrition in children after significant bowel resection. AU - Gonzalez-Hernandez,Jessica, AU - Prajapati,Purvi, AU - Ogola,Gerald, AU - Channabasappa,Nandini, AU - Drews,Barbara, AU - Piper,Hannah G, Y1 - 2017/01/29/ PY - 2016/12/26/received PY - 2017/01/23/accepted PY - 2017/2/9/pubmed PY - 2017/12/16/medline PY - 2017/2/8/entrez KW - Intestinal failure KW - Parenteral nutrition KW - Pediatrics KW - Small bowel length SP - 764 EP - 767 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 52 IS - 5 N2 - PURPOSE: Parenteral nutrition (PN) contributes to considerable morbidity in children after significant bowel resection. This study evaluates the utility of clinical variables in predicting time to independence from PN. METHODS: After IRB approval, a retrospective review (1999-2012) of 71 children who were on PN for >6weeks after intestinal resection and successfully weaned was performed. Clinical characteristics were evaluated to determine the relationship to time to full enteral nutrition. P-values<0.05 were significant. RESULTS: Most children had necrotizing enterocolitis (56%), intestinal atresia (20%), or gastroschisis (11%) with a median small bowel length of 55cm (IQR, 35-92cm). The duration of PN was independent of the etiology of intestinal loss, presence of the ileocecal valve or colon, or location of anastomosis, but was strongly associated with small bowel length (<0.01) and percent of expected small bowel based on gestational age (GA) (median 50%, <0.01). In general, children who had 25-50% of their small bowel were dependent on PN for at least 2years compared to approximately 1year for those with 51-75%. CONCLUSION: The duration of PN dependence in children after major bowel resection is best predicted by remaining small bowel length and can be estimated using a linear regression model. LEVEL OF EVIDENCE: 2b. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/28168985/Predicting_time_to_full_enteral_nutrition_in_children_after_significant_bowel_resection_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(17)30071-4 DB - PRIME DP - Unbound Medicine ER -