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Parenteral nutrition children

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https://www.readbyqxmd.com/read/29778436/enhanced-central-venous-catheter-bundle-for-pediatric-parenteral-dependent-intestinal-failure
#1
Jennifer A Ormsby, Bola Bukoye, Debra Lajoie, Herminia Shermont, Lisa Martin, Kierrah Leger, Judy Mahoney, Gail Potter-Bynoe, Jane Carpenter, Al Ozonoff, Grace M Lee
BACKGROUND: Central line-associated bloodstream infections (CLABSIs) cause substantial morbidity and increase antimicrobial use and length of stay among hospitalized children in the United States. CLABSI occurs more frequently among high-risk pediatric patients, such as those with intestinal failure (IF) who are parenteral nutrition (PN) dependent. Following an increase in CLABSI rates, a quality improvement (QI) initiative was implemented. METHODS: Using QI methodology, an enhanced central venous catheter (CVC) maintenance bundle was developed and implemented on 2 units for pediatric PN-dependent patients with IF...
May 16, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29754463/intestinal-failure-the-evolving-demographic-and-patient-outcomes-on-home-parenteral-nutrition
#2
Sarah Kate Brown, Natalie Davies, Enda Smyth, Nicky Heather, Caroline Cole, Simon Charles Keys, Robert Mark Beattie, Akshay Batra
AIM: We performed this study to examine and understand the evolving demographics and changing outcomes of intestinal failure, and its implications for healthcare delivery. METHOD: We conducted a retrospective analysis of outcome data of children on home Parenteral Nutrition (HPN), over a 15 year period. RESULTS: 31 patients received HPN, 15 for short bowel syndrome (SBS), 8 neuromuscular disease (NMD) and 8 for other causes. The HPN prevalence increased from 1...
May 13, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29752972/urologic-phenotype-and-patterns-of-care-in-patients-with-megacystis-microcolon-intestinal-hypoperistalsis-syndrome-presenting-to-a-major-pediatric-transplantation-center
#3
Lee A Hugar, Rajeev Chaudhry, Thomas W Fuller, Glenn M Cannon, Francis X Schneck, Michael C Ost, Heidi A Stephany
OBJECTIVES: To describe the phenotype, referral pattern, and trends of urologic management for children with megacystis microcolon intestinal hypoperistalsis syndrome. METHODS: We performed a retrospective review of all patients with megacystis microcolon intestinal hypoperistalsis syndrome treated at a large tertiary children's medical center over a 14-year period. Our primary outcomes included the rate of urology referral, urodynamic characteristics of bladder function, and the proportion of patients managed with clean intermittent catheterization...
May 9, 2018: Urology
https://www.readbyqxmd.com/read/29746344/nutritional-considerations-in-pediatric-pancreatitis-a-position-paper-from-the-naspghan-pancreas-committee-espghan-pancreas-working-group
#4
Maisam Abu-El-Haija, Aliye Uc, Steven L Werlin, A Jay Freeman, Miglena Georgieva, Danijela Jojkić - Pavkov, Daina Kalnins, Brigitte Kochavi, Bart G P Koot, Stephanie Van Biervliet, Jaroslaw Walkowiak, Michael Wilschanski, Veronique D Morinville
OBJECTIVES: Wide variations exist in how physicians manage the nutritional aspects of children affected by acute pancreatitis (AP), acute recurrent pancreatitis (ARP) and chronic (CP) pancreatitis. Better consensus for optimal management is needed. METHODS: This consensus statement on nutrition in pediatric pancreatic diseases was developed through a joint ESPGHAN-NASPGHAN working group that performed an evidence-based search of the literature on nutrition in AP, ARP, and CP with a focus on pediatrics...
May 8, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29735029/pediatric-intestinal-transplantation
#5
REVIEW
Neslihan Celik, George V Mazariegos, Kyle Soltys, Jeffrey A Rudolph, Yanjun Shi, Geoffrey J Bond, Rakesh Sindhi, Armando Ganoza
Pediatric intestinal transplantation has moved from the theoretic to an actual therapy for children with irreversible intestinal failure who are suffering from complications of total parenteral nutrition. Owing to significant advancement in the management of intestinal failure and prevention of parenteral nutrition-related complications that have led to reduction in incidence of parenteral nutrition-associated liver disease and have improved intestinal adaptation, the indications for intestinal transplantation are evolving...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29731834/diagnosis-and-treatment-of-postoperative-intestinal-perforation-in-infants-and-young-children-with-congenital-heart-disease-a-report-of-three-cases
#6
Yong-Hong Zhang, Zhen-Liang Chen, Lei Shi, Zhong-Jian Chen, Xiang-Yang Dong, Bo Zhai
The aim of the present study was to analyze risk factors of intestinal perforation following surgery for the treatment of congenital heart disease in infants and young children, and to summarize experiences of diagnosis and treatment. A total of 3,270 children, who underwent congenital heart disease surgery under extracorporeal circulation from January 2010 to July 2015, were retrospectively analyzed. Among these children, three (0.09%) developed postoperative intestinal perforation. Primary diseases were Tetralogy of Fallot (two cases) and ventricular septal defect combined with atrial septal defect (one case)...
May 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29701873/children-with-intestinal-failure-undergoing-intestinal-rehabilitation-are-at-risk-for-essential-fatty-acid-deficiency
#7
Riikka Gunnar, Mirka Lumia, Mikko Pakarinen, Laura Merras-Salmio
BACKGROUND: Essential fatty acid (EFA) status may be compromised during the intestinal failure (IF) rehabilitation. Parenteral lipid restriction is used to treat intestinal failure associated liver disease (IFALD), while the enteral fatty acid (FA) absorption remains limited. We analyzed the FA status among pediatric IF and intestinal insufficiency patients. METHODS: We evaluated 49 patients aged 0-18 years attending our nationwide IF referral center. Their serum FA fractions were determined and examined against previous nutrition, parenteral lipid emulsion, and intestinal anatomy data...
April 27, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29701871/pediatric-intestinal-failure-the-key-outcomes-for-the-first-100-patients-treated-in-a-national-tertiary-referral-center-during-1984-2017
#8
Laura Merras-Salmio, Annika Mutanen, Elisa Ylinen, Risto Rintala, Antti Koivusalo, Mikko P Pakarinen
BACKGROUND: Pediatric-onset intestinal failure (IF) remains a severe illness with life-threatening consequences. In this study, we analyzed a single center's outcomes of IF over 3 decades. METHODS: All children with IF who required parenteral nutrition (PN) >2 months or small-intestinal resection ≥50% managed since 1984 were included for retrospective outcome analyses. RESULTS: In total, 100 patients with median PN duration of 1.2 (interquartile range, 0...
April 27, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29689751/effect-of-standardized-feeding-protocol-on-nutrient-supply-and-postnatal-growth-of-preterm-infants-a-prospective-study
#9
Z Khan, N Morris, H Unterrainer, N Haiden, S J Holasek, B Urlesberger
BACKGROUND: Preterm birth is a medical emergency and it is becoming evident that adequate nutrition starting in the first hours of life is of major importance for short and even more so for long-term health outcomes of the premature newborn. The aim was to analyze postnatal nutrient supply and growth patterns of preterm infants in response to a standardized feeding protocol during stay at neonatal intensive care unit (NICU). METHODS: A prospective cohort study was conducted at NICU, Children Hospital Graz...
2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29628209/outcomes-in-patients-with-short-bowel-syndrome-after-autologous-intestinal-reconstruction-does-etiology-matter
#10
Federica Pederiva, Alberto Sgrò, Riccardo Coletta, Basem Khalil, Antonino Morabito
BACKGROUND: Short bowel syndrome (SBS) is the most common cause of intestinal failure in children. Many factors have been investigated in an attempt to define which parameters influence most survival and ability to wean off parenteral nutrition (PN). The aim of this study was to investigate if aetiology of SBS affects the outcomes in paediatric patients treated with autologous gastrointestinal reconstructive surgery. METHODS: All children with SBS who underwent autologous gastrointestinal reconstructive surgery between 2002 and 2012 were retrospectively reviewed and outcome measures were recorded...
March 12, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29603317/innovative-discharge-process-for-families-with-pediatric-short-bowel-syndrome-a-prospective-nonrandomized-trial
#11
Bram P Raphael, Maria Jorina, Mary Gallotto, Glendalis Grullon, Meghan Dalton, Melissa Takvorian-Bené, Christina Tascione, Carolyn Rosa, Jennifer McClelland, Megan Gray, Alexis K Potemkin, Courtney Glavin, Kathleen M Gura, Margaret K Murphy, Kierrah Leger, Judith Mahoney, Jessica Kerr, Al Ozonoff, Christopher P Duggan
BACKGROUND: Home parenteral nutrition (HPN) is a life-sustaining therapy for short bowel syndrome (SBS) and other severe digestive diseases, but complications are common. We evaluated a predischarge HPN hands-on training course to reduce complications in children with SBS, including hospital readmissions. METHODS: We conducted a prospective, nonrandomized controlled research study between April 1, 2014, and April 30, 2017. Eligible participants were children aged <18 years old with SBS and anticipated HPN dependence duration ≥6 months...
March 30, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29603269/nutrition-delivery-during-pediatric-extracorporeal-membrane-oxygenation-therapy
#12
Lindsey B Armstrong, Katelyn Ariagno, Craig D Smallwood, Charles Hong, Mary Arbuthnot, Nilesh M Mehta
BACKGROUND: Macronutrient delivery during pediatric ECMO therapy can be challenging. We examined predictors of nutrient delivery in the first 2 weeks of extracorporeal membrane oxygenation (ECMO) therapy in the pediatric intensive care unit (ICU). METHODS: Details of macronutrient delivery were recorded in children (newborn-18 years of age) who survived 24 hours after cannulation to ECMO over a 3-year period (2012-2015). RESULTS: We analyzed data from 54 consecutive eligible patients, 43% female, with median (interquartile range) ECMO duration of 8...
March 30, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29602547/ostomy-in-continuity-a-novel-approach-for-the-management-of-children-with-complex-short-bowel-syndrome
#13
Sona Sehgal, Anthony D Sandler, A Alfred Chahine, Parvati Mohan, Clarivet Torres
INTRODUCTION: Despite medical and surgical management, a subset of children with short bowel syndrome (SBS) who have discrepancy between proximal small bowel and distal colon have persistent feeding intolerance. We propose the use of an Ostomy in Continuity (OIC) (Bishop-Koop or Santulli) as a salvage procedure to decompress the proximal bowel while still maintaining maximal intestinal length, in these patients. METHODS: A retrospective chart review of 104 SBS patients identified sixteen patients who underwent an OIC...
March 4, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29602257/neonatal-oesophageal-perforation-the-role-for-non-operative-management
#14
Kate Hodgson, Andrea Togo, Aideen M Moore, Amanda Moody, Sebastian K King, Augusto Zani
AIM: Isolated oesophageal perforation in neonates is a rare but potentially life-threatening condition. Although management has historically been operative, conservative management (antibiotics, bowel rest, parenteral nutrition) is now more routinely used. The aim of this study was to evaluate the management of this condition in two large neonatal surgical centres. METHODS: A retrospective cohort study was conducted for neonates admitted to The Hospital for Sick Children (Toronto, Canada) or The Royal Children's Hospital (Melbourne, Australia) with a diagnosis of oesophageal perforation, from 2006 to 2016...
March 30, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29596284/a-case-of-wernicke-encephalopathy-developing-after-ileal-bypass-surgery
#15
Tülay Kamaşak, Sibel Kul, Mustafa Tuşat, Nezir Ozgun, Ali Cansu
Wernicke encephalopathy is an acute neurological problem resulting from thiamine deficiency and manifesting with mental confusion, oculomotor dysfunction, and ataxia. It is associated with alcohol dependence in adults. Preparatory factors include hyperemesis gravidarum, prolonged diarrhea, prolonged parental nutrition without vitamin support, absorption disorders, anorexia, cancer, and chemotherapy. Failure to consider the clinical findings and preparatory factors of this disease, which is rare in children, can delay diagnosis...
March 28, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29588985/ketogenic-parenteral-nutrition-in-17-pediatric-patients-with-epilepsy
#16
Anastasia Dressler, Nadja Haiden, Petra Trimmel-Schwahofer, Franz Benninger, Sharon Samueli, Gudrun Gröppel, Sina Spatzierer, Angelika Mühlebner, Klaus Abraham, Martha Feucht
Objective: Ketogenic parenteral nutrition (kPN) is indicated when enteral intake is temporarily limited or impossible, but evidence-based prescriptions are lacking. Objective was to evaluate the efficacy and safety of kPN in children with epileptic encephalopathies using a new computer-based algorithm for accurate component calculating. Methods: Children with epilepsy receiving kPN were included. A computer-based algorithm was established on the basis of guidelines of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN): fat intake not exceeding 4 g/kg/day, age-adequate supply of protein, electrolytes, vitamins, and trace elements, but reduced carbohydrates...
March 2018: Epilepsia open
https://www.readbyqxmd.com/read/29582079/2017-update-on-pediatric-medical-overuse-a-review
#17
Eric R Coon, Paul C Young, Ricardo A Quinonez, Daniel J Morgan, Sanket S Dhruva, Alan R Schroeder
Importance: Medical overuse has historically focused on adult health care, but interest in how children are affected by medical overuse is increasing. This review examines important research articles published in 2016 that address pediatric overuse. Observations: A structured search of PubMed and a manual review of the tables of contents of 10 journals identified 169 articles related to pediatric overuse published in 2016, from which 8 were selected based on the quality of methods and potential harm to patients in terms of prevalence and magnitude...
March 26, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29577819/comparison-of-the-efficacy-of-parenteral-and-oral-treatment-for-nutritional-vitamin-b12-deficiency-in-children
#18
Rabia Gönül Sezer, Handan Ayhan Akoğlu, Abdulkadir Bozaykut, Gül Nihal Özdemir
OBJECTIVE: Although, oral replacement for vitamin B12 deficiency has been proved to be effective in adults, it is mainly treated with parenteral therapy. There are only few studies on oral replacement therapy of vitamin B12 with children. Therefore, we aimed to compare the efficacy of oral treatment with intramuscular vitamin B12 injections in pediatric population. METHODS: Children with serum cobalamin concentrations less than 300 pg/mL, were treated either with the parenteral therapy or with oral vitamin B12...
March 24, 2018: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/29571608/physicochemical-stable-standard-all-in-one-parenteral-nutrition-admixtures-for-infants-and-children-in-accordance-with-the-espghan-espen-guidelines
#19
Joeri De Cloet, Stephanie Van Biervliet, Myriam Van Winckel
OBJECTIVE: Because there are almost no standard all-in-one parenteral nutrition admixtures available for infants and children, the aim was to develop standard two-compartment parenteral nutrition bags for different weight categories based on the ESPGHAN/ESPEN (European Society of Paediatric Gastroenterology, Hepatology and Nutrition/European Society for Clinical Nutrition and Metabolism) guidelines. The 1 g/kg/d lipid version for the 3 to 10 kg weight category (PED1) was assessed for short- and long-term physicochemical stability with the ability to add additional electrolytes (PED1+E)...
May 2018: Nutrition
https://www.readbyqxmd.com/read/29570588/hla-dr-expression-on-monocyte-subsets-in-critically-ill-children
#20
Navin P Boeddha, Dorian Kerklaan, Albert Dunbar, Esther van Puffelen, Nicole M A Nagtzaam, Ilse Vanhorebeek, Greet Van den Berghe, Jan A Hazelzet, Koen F Joosten, Sascha C Verbruggen, Willem A Dik, Gertjan J Driessen
BACKGROUND: To longitudinally study blood monocyte subset distribution and human leukocyte antigen-DR (HLA-DR) expression on monocyte subsets in children with sepsis, post-surgery, and trauma in relation to nosocomial infections and mortality. METHODS: In 37 healthy children and 37 critically ill children (12 sepsis, 11 post-surgery, 10 trauma, and 4 admitted for other reasons) - participating in a randomized controlled trial on early versus late initiation of parenteral nutrition - monocyte subset distribution and HLA-DR expression on monocyte subsets were measured by flow cytometry upon admission and on day 2, 3, and 4 of PICU stay...
March 21, 2018: Pediatric Infectious Disease Journal
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