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Pediatric intestinal rehabilitation

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https://www.readbyqxmd.com/read/27849236/treatment-of-short-bowel-syndrome-in-children-value-of-the-intestinal-rehabilitation-program
#1
Uenis Tannuri, Fabio de Barros, Ana Cristina Aoun Tannuri
The main cause of acute intestinal failure is short bowel syndrome, generally as a result of resection of extensive segments of small intestine. As a result, the main symptoms are watery diarrhea, malabsorption syndrome, chronic malnutrition, and death, if the patient is not properly treated. If the length of the remaining intestine is greater than 30 cm, complete adaptation is possible and the patient may not require parenteral nutrition. The currently recommended treatment includes the use of prolonged parenteral nutrition and enteral nutrition, always aimed at constant weight gain, in conjunction with surgeries aimed at elongating the dilated bowel...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27625488/factors-affecting-recovery-of-postoperative-bowel-function-after-pediatric-laparoscopic-surgery
#2
Daphnée Michelet, Juliette Andreu-Gallien, Alia Skhiri, Arnaud Bonnard, Yves Nivoche, Souhayl Dahmani
BACKGROUND AND AIMS: Laparoscopic pediatric surgery allows a rapid postoperative rehabilitation and hospital discharge. However, the optimal postoperative pain management preserving advantages of this surgical technique remains to be determined. This study aimed to identify factors affecting the postoperative recovery of bowel function after laparoscopic surgery in children. MATERIAL AND METHODS: A retrospective analysis of factors affecting recovery of bowel function in children and infants undergoing laparoscopic surgery between January 1, 2009 and September 30, 2009, was performed...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27109978/long-term-outcomes-of-intestinal-and-multivisceral-transplantation-at-a-single-center-in-argentina
#3
D Ramisch, C Rumbo, C Echevarria, L Moulin, S Niveyro, G Orce, A Crivelli, M I Martinez, L Chavez, M A Paez, J Trentadue, F Klein, A Fernández, H Solar, G E Gondolesi
BACKGROUND: Intestinal failure (IF) patients received parenteral nutrition (PN) as the only available therapy until intestinal transplantation (ITx) evolved as an accepted treatment. The aim of this article is to report the long-term outcomes of a series of ITx performed in pediatric and adult patients at a single center 9 years after its creation. PATIENTS AND METHODS: This is a retrospective analysis of the ITx performed between May 2006 and January 2015. Diagnoses, pre-ITx mean time on PN, indications for ITx, time on the waiting list for types of ITx, mean total ischemia time, and warm ischemia time, time until PN discontinuation, incidence of acute and chronic rejection, and 5-year actuarial patient survival are reported...
March 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27067452/change-of-outcomes-in-pediatric-intestinal-failure-use-of-time-series-analysis-to-assess-the-evolution-of-an-intestinal-rehabilitation-program
#4
Carol Oliveira, Nicole T de Silva, Sanja Stanojevic, Yaron Avitzur, Ahmed M Bayoumi, Wendy J Ungar, Jeffrey S Hoch, Paul W Wales
BACKGROUND: The clinical picture of pediatric intestinal failure has changed over the past 15 years, while effectiveness evolving treatment options remains unclear. This study explored evolution in care and quantified independent effects of new treatment options. STUDY DESIGN: Consecutive patients (n = 196) with neonatal or infantile intestinal failure, born between July 1996 and December 2011, were derived from an intestinal rehabilitation program (IRP) patient registry...
June 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/26921935/prevalence-of-renal-abnormality-in-pediatric-intestinal-failure
#5
Christina Kosar, Nicole De Silva, Yaron Avitzur, Karen Steinberg, Glenda Courtney-Martin, Kathryn Chambers, Kevin Fitzgerald, Elizabeth Harvey, Paul W Wales
BACKGROUND: Outcomes of children with intestinal failure have improved over the last decade. However, with improved survival, other co-morbidities have become evident. The goal of our study was to evaluate the presence of renal nephrocalcinosis or increased echogenicity in a cohort of patients with pediatric intestinal failure (PIF). METHODS: A cross-sectional prevalence design was performed in PIF patients followed by our intestinal rehabilitation program between 2013 and 2014...
May 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26897781/-the-world-experience-of-the-pediatric-intestinal-failure-program-successful-outcomes-from-intestinal-rehabilitation
#6
REVIEW
Benyamine Abbou, Igor Sukhotnik, Amnon Rofe
Management of children with short bowel syndrome is optimized by interdisciplinary coordination of parenteral and enteral nutrition support, medical management of associated complications, surgical lengthening procedures, and intestinal transplantation. Pediatric Intestinal Failure Centers were established in 14 pediatric hospitals throughout the United States and Canada and the Pediatric Intestinal Failure Consortium has been developed and is implementing prospective, multi-institutional studies to better define the specific aspects of intestinal failure management that optimize long-term outcomes...
December 2015: Harefuah
https://www.readbyqxmd.com/read/26557183/dry-beriberi-preceded-wernicke-s-encephalopathy-thiamine-deficiency-after-laparoscopic-sleeve-gastrectomy
#7
Debopam Samanta
In recent times, pediatric obesity has become widely prevalent. If first-line treatment with lifestyle modification fails, bariatric surgery may be indicated for severely obese patients. Many patients now travel abroad to get these surgeries done. Some of these patients receive inadequate postoperative care. We described a morbidly obese 17-year-old girl who had a laparoscopic sleeve gastrectomy procedure for weight loss. Due to severe nausea, she stopped her multivitamin supplementation. Within a few weeks, she developed symptoms of dry beriberi was soon followed by classic symptoms of Wernicke's encephalopathy...
July 2015: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/26362005/central-venous-catheter-repair-is-not-associated-with-an-increased-risk-of-central-line-infection-or-colonization-in-intestinal-failure-pediatric-patients
#8
Claire McNiven, Noah Switzer, Melisssa Wood, Rabin Persad, Marie Hancock, Sarah Forgie, Bryan J Dicken
PURPOSE: The intestinal failure (IF) population is dependent upon central venous catheters (CVC) to maintain minimal energy requirements for growth. Central venous catheter infections (CVCI) are frequent and an independent predictor of intestinal failure associated liver disease. A common complication in children with long-term CVC is the risk of line breakage. Given the often-limited usable vascular access sites in this population, it has been the standard of practice to perform repair of the broken line...
March 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26059898/the-fecal-microbiome-in-pediatric-patients-with-short-bowel-syndrome
#9
Zev H Davidovics, Beth A Carter, Ruth Ann Luna, Emily B Hollister, Robert J Shulman, James Versalovic
BACKGROUND: Changes in the intestinal microbiome of patients with short bowel syndrome (SBS) are thought to significantly affect clinical outcome. These changes may not only delay enteral diet advancement but may also predispose patients to bacterial translocation, bacteremia, and liver disease. Patients with SBS are thought to be more susceptible to changes in gut microbial communities due to intestinal dysmotility and/or lack of anatomic safeguards such as the ileocecal valve. MATERIALS AND METHODS: We analyzed the bacterial composition of 21 fecal specimens from 9 children with SBS and 8 healthy children ages 4 months to 8 years by 16S ribosomal RNA gene sequencing...
November 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/25820764/autologous-intestinal-reconstruction-surgery-as-part-of-comprehensive-management-of-intestinal-failure
#10
REVIEW
Mikko P Pakarinen
Pediatric intestinal failure (IF) remains to be associated with significant morbidity and mortality, the most frequent underlying etiologies being short bowel syndrome (SBS), and primary motility disorders. Management aims to assure growth and development, while preventing complications and facilitating weaning off parenteral support (PS) by fully utilizing adaptation potential of the remaining gut. Probability of survival and weaning off PS is improved by coordinated multidisciplinary intestinal rehabilitation combining individualized physiological enteral and parenteral nutrition (PN), meticulous central line care and medical management with carefully planned surgical care...
May 2015: Pediatric Surgery International
https://www.readbyqxmd.com/read/25421304/surgical-rehabilitation-of-short-and-dysmotile-intestine-in-children-and-adults
#11
COMPARATIVE STUDY
Maria Hukkinen, Laura Merras-Salmio, Taina Sipponen, Annika Mutanen, Risto J Rintala, Heikki Mäkisalo, Mikko P Pakarinen
AIMS: This is a descriptive study aiming to compare outcomes of intestinal rehabilitation surgery among pediatric and adult intestinal failure (IF) patients with either primary intestinal motility disorders or short bowel syndrome (SBS) treated by our nationwide program. METHODS: Medical records of IF patients (n = 31, 71% children) having undergone autologous intestinal reconstructions (AIR) (n = 25), intestinal transplantation (ITx) (n = 5), or being listed for ITx (n = 2) between 1994 and 2014 were reviewed...
February 2015: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/25111276/nursing-intervention-for-outpatient-rehabilitation-in-pediatric-patients-with-hirschsprung-disease-after-colectomy
#12
RANDOMIZED CONTROLLED TRIAL
Hui Wang, Xia-Ne Guo, Dan Zhu, Tianqi Zhu, Lu-Hong Hu, Jie-Xiong Feng
OBJECTIVE: The present study was designed to evaluate the effectiveness of a nursing intervention program for outpatient rehabilitation of children with Hirschsprung-associated enterocolitis (HAEC) after radical colectomy for Hirschsprung disease (HD). BACKGROUND: Postoperative outcomes severely affect the quality of life in pediatric HD patients after operation. The improvement in defecation function is regarded as one of the most useful parameters to evaluate the quality of life in HD patients after radical intestinal resection...
October 2015: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/24696095/a-s-p-e-n-clinical-guidelines-support-of-pediatric-patients-with-intestinal-failure-at-risk-of-parenteral-nutrition-associated-liver-disease
#13
REVIEW
Paul W Wales, Nancy Allen, Patricia Worthington, Donald George, Charlene Compher, Daniel Teitelbaum
BACKGROUND: Children with severe intestinal failure and prolonged dependence on parenteral nutrition are susceptible to the development of parenteral nutrition-associated liver disease (PNALD). The purpose of this clinical guideline is to develop recommendations for the care of children with PN-dependent intestinal failure that have the potential to prevent PNALD or improve its treatment. METHOD: A systematic review of the best available evidence to answer a series of questions regarding clinical management of children with intestinal failure receiving parenteral or enteral nutrition was undertaken and evaluated using concepts adopted from the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group...
July 2014: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/24594083/recent-advances-in-the-management-of-pediatric-intestinal-failure
#14
REVIEW
Chan-Fai Chan, Tzee-Chung Wu
Intestinal failure is a chronic condition in which the intestinal tract has lost most of its function. Prognosis depends on the severity and underlying etiologies. Although many patients survive under parenteral nutrition support, they often suffer from fatal complications such as progressive cholestasis and frequent sepsis. In addition, to decide the proper time to refer selected patients to bowel transplantation remains difficult. A noninvasive biomarker developed to evaluate functional enterocyte mass and the extent of intestinal adaptation is plasma citrulline level...
December 2014: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/24439573/intestinal-transplantation-an-unexpected-journey-robert-e-gross-lecture
#15
Jorge D Reyes
The development of pediatric intestine transplantation has required continuous refinements in the management of intestinal failure, surgical technique, and perioperative care. The development of better immunosuppressive management (cyclosporine in 1978 and tacrolimus in 1989) and enhancements in our understanding of the relationship between recipient and host immune systems have resulted in better long-term survival. Paralleling this, advancements in the organ procurement techniques and organ preservation solutions have made possible the procurement and transplantation of various types of intestine containing grafts tailored to the needs of the various indications for which intestine transplantation is being performed...
January 2014: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/23866718/successful-rehabilitation-in-pediatric-ultrashort-small-bowel-syndrome
#16
Benjamin J Infantino, David F Mercer, Brandy D Hobson, Ryan T Fischer, Brandi K Gerhardt, Wendy J Grant, Alan N Langnas, Rubén E Quiros-Tejeira
OBJECTIVE: To examine treatment outcomes in pediatric patients with ultrashort small bowel (USSB) syndrome in an intestinal rehabilitation program (IRP). STUDY DESIGN: We reviewed IRP records for 2001-2011 and identified 28 children with USSB (≤ 20 cm of small bowel). We performed univariate analysis using the Fisher exact test and Wilcoxon rank-sum test to compare characteristics of children who achieved parenteral nutrition (PN) independence with intact native bowel and those who did not...
November 2013: Journal of Pediatrics
https://www.readbyqxmd.com/read/23701771/the-impact-of-multi-disciplinary-intestinal-rehabilitation-programs-on-the-outcome-of-pediatric-patients-with-intestinal-failure-a-systematic-review-and-meta-analysis
#17
REVIEW
Jennifer D Stanger, Carol Oliveira, Christopher Blackmore, Yaron Avitzur, Paul W Wales
BACKGROUND: Pediatric intestinal failure (IF) is a complex clinical problem requiring coordinated multi-disciplinary care. Our objective was to review the evidence for the benefit of intestinal rehabilitation programs (IRP) in pediatric IF patients. METHODS: A systematic review was performed on Medline (1950-2012), Pubmed (1966-2012), and Embase (1980-2012) conference proceedings and trial registries. The terms short bowel syndrome, intestinal rehabilitation, intestinal failure, patient care teams, and multi-disciplinary teams were used...
May 2013: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/22984711/intestinal-failure-improve-care-project-at-arkansas-children-s-hospital
#18
Juliana C Frem, Laura Buse
Intestinal Failure is a complex and chronic condition that is challenging to patients, their families and their physicians. The intestinal rehabilitation team at Arkansas Children's Hospital adopts a multidisciplinary approach aimed at improving the outcomes of patients with Intestinal failure. The Intestinal Failure Improve Care Project will achieve these objectives through care coordination and monitoring, education and training of health care providers and families, pre-planned visits, and applications of evidence-based guidelines...
August 2012: Journal of the Arkansas Medical Society
https://www.readbyqxmd.com/read/22813789/impact-of-infantile-short-bowel-syndrome-on-long-term-health-related-quality-of-life-a-cross-sectional-study
#19
Joanne F Olieman, Corine Penning, Marten J Poley, Elisabeth M W J Utens, Wim C J Hop, Dick Tibboel
BACKGROUND/PURPOSE: Studies on the long-term effects of short bowel syndrome (SBS) on the quality of life are scarce. Therefore, we determined health-related quality of life (HRQoL) in children and adolescents with a history of infantile SBS compared with that of same-aged controls drawn from the general population. METHODS: Cross-sectional assessment (2005-2007) of HRQoL in children with a history of infantile SBS treated in their first year of life, born between 1987 and 2002, using generic HRQoL measures was performed...
July 2012: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/22528662/medical-update-and-potential-advances-in-the-treatment-of-pediatric-intestinal-failure
#20
REVIEW
Nader N Youssef, Adam G Mezoff, Beth A Carter, Conrad R Cole
Short bowel syndrome (SBS) and intestinal failure are chronic malabsorption disorders with considerable nutritional and growth consequences in children. Intestinal failure occurs when the functional gastrointestinal mass is reduced even if there is normal anatomical gastrointestinal length. A number of management strategies are often utilized to achieve successful intestinal rehabilitation and maintain adequate nutrition to avoid intestinal transplant. These strategies include minimizing the effect of parenteral associated liver disease, limiting catheter complications, and treating bacterial overgrowth in the remaining small intestine...
June 2012: Current Gastroenterology Reports
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