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Parenteral nutrition children

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https://www.readbyqxmd.com/read/28531419/current-practices-and-experience-of-transition-of-young-people-on-long-term-home-parenteral-nutrition-pn-to-adult-services-a-perspective-from-specialist-centres
#1
E Kyrana, S V Beath, S Gabe, M Small, S Hill
BACKGROUND: There has been an estimated fivefold increase in the number of children receiving parenteral nutrition (PN) at home in the past 10 years with some children approaching the age when they should be referred to adult services whilst still on treatment. Models of care for moving young people onto adult providers of PN at home are not yet well developed, and transition is a potentially dangerous time for young people with complex health needs. METHODS: A questionnaire to ascertain current experience and practices of transition in the context of home PN services was dispatched to 170 consultant gastroenterologists who were members of the British Association of Parenteral and Enteral Nutrition (BAPEN) and also to all 40 members of the Nutrition and IF working group of the British Society of Paediatric Gastroenterology and Nutrition (BSPGHAN)...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28522351/effect-of-early-supplemental-parenteral-nutrition-in-the-paediatric-icu-a-preplanned-observational-study-of-post-randomisation-treatments-in-the-pepanic-trial
#2
Ilse Vanhorebeek, Sascha Verbruggen, Michaël P Casaer, Jan Gunst, Pieter J Wouters, Jan Hanot, Gonzalo Garcia Guerra, Dirk Vlasselaers, Koen Joosten, Greet Van den Berghe
BACKGROUND: Large randomised controlled trials have shown that early supplemental parenteral nutrition in patients admitted to adult and paediatric intensive care units (PICUs) is harmful. Overdosing of energy with too little protein was suggested as a potential reason for this. This study analysed which macronutrient was associated with harm caused by early supplemental parenteral nutrition in the Paediatric Early versus Late Parenteral Nutrition In Critical Illness (PEPaNIC) randomised trial...
May 15, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28521656/oral-feeding-difficulties-in-children-with-short-bowel-syndrome-a-narrative-review
#3
Judy Hopkins, Sharon A Cermak, Russell J Merritt
Children with short bowel syndrome (SBS) with associated intestinal failure may be unable to absorb sufficient nutrients to sustain life. Improvements in the medical management of SBS, including use of parenteral nutrition, has significantly increased life expectancy. Independence from parenteral nutrition further improves quality of life. However, children living with SBS often develop oral aversions and feeding difficulties. There is limited research and information on which to base interventions that will preserve and develop oral motor and feeding skills...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28510260/markers-of-enteral-adaptation-in-pediatric-cases-with-short-bowel-syndrome
#4
Masahiro Chiba, Yutaka Sanada, Akira Toki
BACKGROUND: This study aimed to ascertain if prospective determinations of specific gut hormones and growth factors could predict bowel adaptation in children with short bowel syndrome (SBS). METHODS: We studied parenteral nutrition (PN) independency as the short-term result and discontinuation of enteral nutrition (EN) as the long-term result from a retrospective chart review of 7 patients with SBS, who were managed in the absence of growth retardation. The correlation between increased numbers of enteral feedings or enteral nutrients and fasting levels of serum gastrin, glucagon-like peptide 2 (GLP-2), citrulline, and diamine oxidase (DAO) activity was analyzed...
May 16, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28497760/the-intestinal-microbiome-and-paediatric-liver-disease
#5
REVIEW
Daniel H Leung, Dean Yimlamai
The intestinal microbiome has been the intense focus of recent study, but how the microbiota affects connected organs, such as the liver, has not been fully elucidated. The microbiome regulates intestinal permeability and helps to metabolise the human diet into small molecules, thus directly affecting liver health. Several studies have linked intestinal dysbiosis to the severity and progression of liver diseases, such as non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, primary sclerosing cholangitis, total parenteral nutrition-associated liver disease, and cystic fibrosis-associated liver disease...
June 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28494608/parenteral-nutrition-in-childhood-and-consequences-for-dentition-and-gingivae
#6
D Olczak-Kowalczyk, M Danko, E Banaś, D Gozdowski, K Popińska, E Krasuska-Sławińska, J Książyk
AIM: Assessment of dentition in children under parenteral nutrition, risk factors for caries, and dental developmental abnormalities. MATERIALS AND METHODS: The study involved 63 patients (aged 2.25-16.6 years), i.e. 32 subjects receiving parenteral nutrition for a mean period of 5.6±2.94 years, and 31 healthy control subjects. Oral hygiene (OHI-S, PL-I), gingival (GI), and dentition status (caries, DMFT/dmft, enamel defects, shape alterations), frequency of oral meals and frequency of cariogenic snacks consumption were evaluated...
March 2017: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/28486543/preterm-brain-injury-on-term-equivalent-age-mri-in-relation-to-perinatal-factors-and-neurodevelopmental-outcome-at-two-years
#7
Margaretha J Brouwer, Karina J Kersbergen, Britt J M van Kooij, Manon J N L Benders, Ingrid C van Haastert, Corine Koopman-Esseboom, Jeffrey J Neil, Linda S de Vries, Hiroyuki Kidokoro, Terrie E Inder, Floris Groenendaal
OBJECTIVES: First, to apply a recently extended scoring system for preterm brain injury at term-equivalent age (TEA-)MRI in a regional extremely preterm cohort; second, to identify independent perinatal factors associated with this score; and third, to assess the prognostic value of this TEA-MRI score with respect to early neurodevelopmental outcome. STUDY DESIGN: 239 extremely preterm infants (median gestational age [range] in weeks: 26.6 [24.3-27.9]), admitted to the Wilhelmina Children's Hospital between 2006 and 2012 were included...
2017: PloS One
https://www.readbyqxmd.com/read/28483165/variability-in-outcomes-after-gastroschisis-closure-across-u-s-children-s-hospitals
#8
Dani O Gonzalez, Jennifer N Cooper, Shawn D St Peter, Peter C Minneci, Katherine J Deans
BACKGROUND: In patients undergoing gastroschisis closure, the effects of timing of closure and patient and hospital-level characteristics on length of stay (LOS) and time to enteral autonomy are unknown. STUDY DESIGN: Using the Pediatric Health Information System, we compared neonates who underwent early (within 1day of birth) versus delayed (>1day after birth) gastroschisis closure from 2005 to 2013. We evaluated the relationship between time to closure and both LOS and days on total parenteral nutrition (TPN)...
April 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28433363/the-molecular-impact-of-omega-3-fatty-acids-on-hepatic-pro-inflammatory-cytokine-signaling
#9
George J Ventro, Yingkui Yang, Min Chen, Carroll M Harmon
PURPOSE: Parenteral nutrition associated liver disease (PNALD) develops in a subset of children receiving parenteral nutrition for intestinal failure. Omegaven™ is an omega-3 fatty acid (Ω3FA) lipid emulsion high in docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) that can lessen PNALD. Inflammatory cytokines (IL-1, TNF-α, TGF-β) are elevated in PNALD and can decrease paraoxonase 1 protein expression (PON1). We sought to determine the effect of Omegaven™, EPA, and DHA on inflammatory cytokines TNF-α, IL-1, and TGF-β via ERK1/2 and p-Smad2/3 signaling pathways as well as the changes in intracellular PON1 protein expression as a potential mechanism explaining the protective effects of Omegaven™ and Ω3FA...
March 18, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28376054/timing-of-the-initiation-of-parenteral-nutrition-in-critically-ill-children
#10
Lissette Jimenez, Nilesh M Mehta, Christopher P Duggan
PURPOSE OF REVIEW: To review the current literature evaluating clinical outcomes of early and delayed parenteral nutrition initiation among critically ill children. RECENT FINDINGS: Nutritional management remains an important aspect of care among the critically ill, with enteral nutrition generally preferred. However, inability to advance enteral feeds to caloric goals and contraindications to enteral nutrition often leads to reliance on parenteral nutrition. The timing of parenteral nutrition initiation is varied among critically ill children, and derives from an assessment of nutritional status, energy requirements, and physiologic differences between adults and children, including higher nutrient needs and lower body reserves...
May 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28361844/new-mutations-of-epcam-gene-for-tufting-enteropathy-in-saudi-arabia
#11
Shaden AlMahamed, Abdelhai Hammo
BACKGROUND/AIM: Tufting enteropathy (TE) is a rare cause of congenital intractable diarrhea in children. It often results in an irreversible intestinal failure and total parenteral nutrition (TPN) dependency; eventually, intestinal transplantation may be necessary. Data on TE from the Middle East are scarce; therefore, our aim of conducting this study was to clarify the clinical, histopathologic, and molecular features of TE in Saudi children. PATIENTS AND METHODS: This was a retrospective chart review of four children with TE who presented between January 2011 and December 2013 to King Fahad Specialist Hospital-Dammam (KFSH-D)...
March 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/28355492/longitudinal-bone-mineralization-assessment-in-children-treated-with-long-term-parenteral-nutrition-for-severe-intestinal-failure
#12
Pierre Poinsot, Perrine Geoffroy, Pierre Braillon, Angelique Denis, Irene Loras-Duclaux, Stéphanie Marotte, Stéphanie Boutroy, Justine Bacchetta, Sandrine Touzet, Alain Lachaux, Noel Peretti
BACKGROUND: Metabolic bone disease is common in children receiving home parenteral nutrition (HPN) for intestinal failure (IF). Long-term evolution of bone mass in pediatric IF is poorly documented. The aims of this study were (1) to determine the prevalence of low bone mass (LBM) in children receiving HPN for IF, (2) to evaluate the evolution of total bone mineral content (TBMC) during HPN with dual-energy x-ray absorptiometry (DXA), and (3) to identify related factors. METHODS: All children referred in our HPN center from 2004 to 2014 were eligible...
March 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28340493/conservative-treatment-with-octreotide-to-provide-early-recovery-of-children-with-esophageal-perforation
#13
Ramazan Karabulut, Zafer Turkyilmaz, Kaan Sonmez, Abdullah Can Basaklar
Background The effectiveness of nonoperative treatment of esophageal perforation (EP) in children with octreotide is highlighted. Methods Records of nine patients (seven boys and two girls with an average age of 5.83 ± 5.35 years) with EP were reviewed. Results EP developed in six patients during dilation of esophageal stenosis (five of six caused by caustic burns). In the other three patients, EP developed after nasogastric placement, after endotracheal intubation, and during endoscopy for foreign body...
March 24, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28330584/central-line-associated-sepsis-in-children-receiving-parenteral-nutrition-in-oman
#14
Tawfiq T Al Lawati, Adawaiya Al Jamie, Nasra Al Mufarraji
Parenteral Nutrition (PN) is used when gut fails to provide complete nutrition. Central line Associate Blood Stream Infection (CLABSI) a major complication of this therapy. The objective of the study was to report the incidence of CLABSI and associated mortality in children receiving PN in the Royal Hospital and study the indication and duration of PN use. All children from the age of 0-48 months who received TPN outside NICU from the period between 1/1/2011 till 31/12/2014 were included. Data were retrieved from the hospital electronic data base...
March 16, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28323667/central-venous-access-in-children-indications-devices-and-risks
#15
Guillermo Ares, Catherine J Hunter
PURPOSE OF REVIEW: Central venous catheters (CVCs) have a prominent role in the diagnostic and therapy of neonates and children. Herein, we describe the multiple indications for CVC use and the different devices available for central venous access. Given the prevalent use of CVCs, healthcare systems are focused on reducing complications from their use, particularly central line-associated bloodstream infections (CLABSIs). The most up-to-date information available sheds light on best practices and future areas of investigation...
June 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28274657/bone-health-of-children-with-intestinal-failure-measured-by-dual-energy-x-ray-absorptiometry-and-digital-x-ray-radiogrammetry
#16
Esther Neelis, Noortje Rijnen, Johanna Sluimer, Joanne Olieman, Dimitris Rizopoulos, René Wijnen, Edmond Rings, Barbara de Koning, Jessie Hulst
BACKGROUND & AIMS: Children with intestinal failure (IF) receiving long-term parenteral nutrition (PN) are at risk of developing low bone mineral density (BMD). Next to the dual energy X-ray absorptiometry (DXA) method, digital X-ray radiogrammetry (DXR) using the BoneXpert software has become available to obtain the Bone Health Index (BHI) in hand radiographs. In this study we 1) evaluated the prevalence of low BMD in children with IF using DXA and DXR, 2) compared DXA and DXR results, and 3) aimed to identify factors associated with low BMD...
February 21, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28209419/a-safety-and-pharmacokinetic-dosing-study-of-glucagon-like-peptide-2-in-infants-with-intestinal-failure
#17
David L Sigalet, Mary E Brindle, Dana Boctor, Bryan Dicken, Viona Lam, Lily Sia Lu, Elaine de Heuvel, Bolette Hartmann, Jens J Holst
BACKGROUND & AIMS: Glucagon-like peptide 2 (GLP-2) analogues are approved for adults with intestinal failure (IF), but no studies have included infants. This study examined the pharmacokinetics (PK), safety, and nutritional effects of GLP-2 in infants with IF. METHODS: With parental consent (Health Canada Protocol:150,979), parenteral nutrition (PN)-dependent infants were treated with 5-20-μg/kg/day GLP-2 for 3days (phase 1), and if tolerated continued for 42days (phase 2)...
May 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28190552/use-of-balloon-dilatation-for-management-of-postoperative-intestinal-strictures-in-children-with-short-bowel-syndrome
#18
Christina Belza, Kevin Fitzgerald, Joao Amaral, Karen Steinberg, Yaron Avitzur, Paul W Wales
PURPOSE: Children with short bowel syndrome (SBS) often require numerous operations to optimize intestinal function. Postoperative intestinal strictures are a complication that inhibits enteral feeding advancement and prolongs parenteral nutrition dependency, often requiring reoperation. Our objective was to review our experience with fluoroscopic balloon dilatation to treat intestinal strictures. METHODS: A retrospective cohort study of intestinal failure patients with SBS was completed...
May 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28185632/risk-factors-and-outcomes-of-tapering-surgery-for-small-intestinal-dilatation-in-pediatric-short-bowel-syndrome
#19
Maria Hukkinen, Reetta Kivisaari, Antti Koivusalo, Mikko P Pakarinen
BACKGROUND: In remains unclear why in some short bowel syndrome (SBS) patients, the remaining small bowel (SB) dilates excessively leading to requirement of tapering surgery. METHODS: Among SBS children, we retrospectively analyzed risk factors for tapering surgery with logistic regression and compared the outcome of operated patients (n=16) to those managed conservatively (n=44) with Cox proportional hazards regression. RESULTS: SBS was caused by necrotizing enterocolitis (NEC) (n=31), SB atresia (SBA) (n=13), midgut volvulus (n=12), or gastroschisis (n=4)...
January 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28181921/feed-induced-dystonias-in-children-with-severe-central-nervous-system-disorders
#20
Santosh Mordekar, Manjula Velayudhan, David I Campbell
Dystonias can arise from any painful stimuli in neurologically disabled children. Classically, feed induced dystonias from mediastinal pain due to severe gastroesophageal reflux disease are described as Sandifer's spasm. We report a case series of 12 severely neurologically impaired children with enteral feed induced dystonias. Intestinal dysmotility was demonstrated in several. Improvements are seen with jejunal feeds or gut rest with Total Parenteral Nutrition. Use of parenteral nutrition in children with severe neurodisability requires thorough discussion with patient groups and commissioners to give clinicians guidelines to standardise care...
February 8, 2017: Journal of Pediatric Gastroenterology and Nutrition
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