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Pediatric Parenteral nutrition

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https://www.readbyqxmd.com/read/28600116/features-of-nonalcoholic-steatohepatitis-in-severely-obese-children-and-adolescents-undergoing-sleeve-gastrectomy
#1
Aayed Alqahtani, Mohamed Elahmedi, Khalid Alswat, Maha Arafah, Mosa Fagih, Jaehoon Lee
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is an underrecognized co-morbidity of obesity. The characteristic features and severity of NAFLD in severe childhood obesity remain unknown. OBJECTIVES: To investigate features of NAFLD in obese children and identify predictors of significant disease. SETTING: Academic center with a standardized pathway for pediatric bariatric surgery and a dedicated multidisciplinary team. DESIGN: This is a baseline cross-sectional analysis for a data set obtained from a prospective clinical outcome study that included severely obese children (≤14 yr of age) and adolescents (14-21 yr of age) who underwent laparoscopic sleeve gastrectomy between March 2008 and March 2015...
April 7, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28590353/proposed-clinical-pathway-for-non-operative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#2
Bindi J Naik-Mathuria, Eric H Rosenfeld, Adam Vogel, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Alex Ler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for non-operative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers in order to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (AAST grade III-V) pancreatic injuries treated with NOM between 2010-15...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28574294/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#3
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and <18 years) expected to require a length of stay >2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28550876/neonatal-and-pediatric-esophageal-perforation
#4
Rebecca M Rentea, Shawn D St Peter
Esophageal perforation (EP) is a rare complication that is often iatrogenic in origin. In contrast with adult patients in whom surgical closure of the defect is preferred, nonoperative treatment has become a common therapeutic approach for EP in neonates and children. Principles of management pediatric EP includes rapid diagnosis, appropriate hemodynamic monitoring and support, antibiotic therapy, total parenteral nutrition, control of extraluminal contamination, and restoration of luminal integrity either through time or operative approaches...
April 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28510260/markers-of-enteral-adaptation-in-pediatric-cases-with-short-bowel-syndrome
#5
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/28483165/variability-in-outcomes-after-gastroschisis-closure-across-u-s-children-s-hospitals
#6
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/28481068/-early-parenteral-nutrition-in-complex-post-operative-periods
#7
A I Molina Caballero, A Pérez Martínez, S Hernández Martín, N González Temprano, L Ayuso González, J Pisón Chacón
OBJECTIVE: The protein hypercatabolic state in critically ill pediatric patients can be minimized by an effective nutrition therapy. We conducted a study to evaluate the benefits of early parenteral nutrition (EPN) assessing its effect on nutritional parameters and clinical relevance after complex surgical procedures. METHODS: Prospective randomized study in patients undergoing abdominal surgery in which nothing by mouth is anticipated for a period ≥ 3 days, between 2012 and 2014...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28434083/predictors-of-a-successful-outcome-for-infants-with-short-bowel-syndrome-a-30-year-single-institution-experience
#8
Tatsuru Kaji, Kazuhiko Nakame, Seiro Machigashira, Takafumi Kawano, Ryuta Masuya, Waka Yamada, Koji Yamada, Shun Onishi, Tomoe Moriguchi, Koshiro Sugita, Motoi Mukai, Satoshi Ieiri
PURPOSE: Short-bowel syndrome (SBS) is associated with high morbidity and mortality. We conducted this study to establish the predictors of survival and weaning off parenteral nutrition (PN). METHODS: We reviewed the medical records of 16 SBS infants treated at our institution within a 30-year period. SBS was defined as a residual small-bowel length (RSBL) of <75 cm. Loss of the ileocecal valve (ICV), cholestasis (D-Bil >2.0 mg/dl), enterostomy, and RSBL were all evaluated...
April 22, 2017: Surgery Today
https://www.readbyqxmd.com/read/28425133/fecal-microbiota-signatures-of-adult-patients-with-different-types-of-short-bowel-syndrome
#9
Yuhua Huang, Feilong Guo, Yousheng Li, Jian Wang, Jieshou Li
BACKGROUND AND AIM: Short bowel syndrome (SBS) is a common cause of intestinal failure and can be divided into three types depending on intestinal anatomy. Gut dysbiosis has been observed in pediatric SBS patients and is associated with impaired outcome. Little is known about the changes in gut microbiota of adult SBS patients. Therefore, we aim to characterize the fecal microbiota of adult patients with different types of SBS. METHODS: Fifteen fecal samples from healthy controls and adult patients with type II or type III SBS were collected (five in each group)...
April 19, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28393502/-peripherally-inserted-central-catheters-savings-comfort-many-advantages
#10
A Y Molina Caballero, M Martínez Merino, A Pérez Martínez, L Ayuso González, S Hernández Martín, J Pisón Chacón
INTRODUCTION: Peripherally inserted central catheters are indicated when an intravenous treatment is expected for more than 6 days or less if phlebotoxic medication is used. We report our recent experience. METHODS: Retrospective study from 2014 to 2015 including patients to whom a catheter was placed either, in the operating room after surgery and before awakening the patient, or in the Pediatric ICU by direct or ultrasound guidance venipuncture. We reviewed patient characteristics, underlying disease, line catheterization procedure, type and duration of venous line, intravenous treatment and complications...
July 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28378134/pediatric-short-bowel-syndrome-and-subsequent-development-of-inflammatory-bowel-disease-an-illustrative-case-and-literature-review
#11
Katherine J Baxter, Jahnavi K Srinivasan, Thomas R Ziegler, Tanvi Dhere, Richard R Ricketts, Megan M Durham
Short bowel syndrome (SBS) in neonates is an uncommon but highly morbid condition. As SBS survival increases, physiologic complications become more apparent. Few reports in the literature elucidate outcomes for adults with a pediatric history of SBS. We present a case report of a patient, born with complicated gastroschisis resulting in SBS at birth, who subsequently developed symptoms and pathologic changes of inflammatory bowel disease (IBD) as an adult. The patient lived from age 7, after a Bianchi intestinal lengthening procedure, to age 34 independent of parenteral nutrition (PN), but requiring hydration fluid via G-tube...
June 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28376054/timing-of-the-initiation-of-parenteral-nutrition-in-critically-ill-children
#12
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/28355492/longitudinal-bone-mineralization-assessment-in-children-treated-with-long-term-parenteral-nutrition-for-severe-intestinal-failure
#13
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/28323667/central-venous-access-in-children-indications-devices-and-risks
#14
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/28306567/use-of-parenteral-nutrition-in-the-pediatric-icu-should-we-panic-because-of-pepanic
#15
Berthold Koletzko, Olivier Goulet, Frank Jochum, Raanan Shamir
No abstract text is available yet for this article.
May 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28188037/determinants-of-outcomes-in-patients-with-simple-gastroschisis
#16
Fouad Youssef, Jean-Martin Laberge, Pramod Puligandla, Sherif Emil
PURPOSE: We analyzed the determinants of outcomes in simple gastroschisis (GS) not complicated by intestinal atresia, perforation, or necrosis. METHODS: All simple GS patients enrolled in a national prospective registry from 2005 to 2013 were studied. Patients below the median for total parenteral nutrition (TPN) duration (26days) and hospital stay (34days) were compared to those above. Univariate and multivariate logistic and linear regression analyses were employed using maternal, patient, postnatal, and treatment variables...
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
#17
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/28149146/antifungal-susceptibility-and-risk-factors-in-patients-with-candidemia
#18
Cigdem Mermutluoglu, Ozcan Deveci, Saim Dayan, Emel Aslan, Fatma Bozkurt, Recep Tekin
OBJECTIVE: This study aimed to investigate the antifungal susceptibility, typology, and risk factors of candidemia among adult and pediatric inpatients at a university hospital. MATERIALS AND METHODS: A case-control study was designed, and data collected between December 2013 and December 2014 were retrospectively evaluated. The case group consisted of patients with candidemia. The control group was selected from the inpatients that did not develop candidemia but were admitted in the same clinic and during the same period as the candidemia group...
October 2016: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28119937/congenital-chylous-ascites-and-ehlers-danlos-syndrome-type-vi
#19
Anna K Ermarth, John Pohl, Brittany Esty, Jessica K Sempler, John C Carey, Molly A O'Gorman
We report the first observation of a patient with contgenital chylous ascites (CCA) and Ehlers-Danlos syndrome type VI due to primary lymphatic defect with additional vascular anomaly. CCA is a rare condition, and there is limited understanding of its pathophysiology and treatment options. We also review the patient's treatment course mitigated with octreotide and total parenteral nutritional support, as there are no current established guidelines for CCA. Early recognition of possible association with Ehlers-Danlos syndrome is important for quick intervention and successful management of pediatric patients...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28052886/intestinal-rehabilitation-for-children-with-intestinal-failure-is-cost-effective-a-simulation-study
#20
Henk Groen, Esther G Neelis, Marten J Poley, Joanne F Olieman, René Scheenstra, Paul Fm Krabbe, Gerard Dijkstra, Edmond Hhm Rings
BACKGROUND: Children with intestinal failure (IF) depend on parenteral nutrition (PN). The goal in the treatment of IF is to wean children off PN through intestinal rehabilitation (IR). Although the healthcare burden of IF is enormous, to our knowledge there has been no previous cost-effectiveness analysis in pediatric IF including IR. OBJECTIVE: We sought to determine the cost-effectiveness of IR in terms of costs and life-years. DESIGN: We simulated the treatment of IF in children in a discrete-event model...
February 2017: American Journal of Clinical Nutrition
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