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Complications in neonates with short bowel syndrome and long-term parenteral nutrition
S Suita1, K Masumoto, T Yamanouchi
1Department of Pediatric Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Insights
Long-term parenteral nutrition (PN) improves survival for short bowel syndrome (SBS) patients but can cause complications. Hepatic dysfunction and micronutrient imbalances like manganese deposition require careful monitoring for better patient outcomes.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Nutritional Science
Background:
- Advances in parenteral nutrition (PN) have significantly improved survival rates for patients with short bowel syndrome (SBS).
- Infants with very short small bowels (20 cm) can now survive with PN support.
- Prolonged PN therapy is associated with severe complications.
Purpose of the Study:
- To investigate the complications of long-term PN in patients with SBS.
- To specifically examine the incidence of hepatic dysfunction, micronutrient deficiencies, and intoxication.
Main Methods:
- Analysis of 17 patients with SBS undergoing long-term PN.
- Assessment of hepatic function, micronutrient levels, and signs of intoxication.
Main Results:
- Hepatic dysfunction, primarily cholestasis, was observed in 11 out of 17 patients (64.7%).
- Common causes of hepatic dysfunction included loss of enteral feeding and infections.
- While zinc and copper deficiencies were reduced by supplements, one patient showed manganese deposition in the basal ganglia.
Conclusions:
- Increased attention to PN-related complications is crucial for improving SBS patient prognosis.
- Monitoring for hepatic dysfunction and micronutrient imbalances, including manganese toxicity, is essential.
Background:
Because of advances in parenteral nutrition (PN), the prognosis for patients with short bowel syndrome (SBS) has recently shown great improvement. Even infants with a small bowel measuring only 20 cm either with or without an ileocoecal valve can now survive. However, because of the increased periods of PN, severe complications associated with PN have been observed.
Patients And Methods:
We analyzed 17 patients with SBS treated by long-term PN to investigate the complications of PN, particularly hepatic dysfunction, micronutrient deficiency, and intoxication.
Results:
Eleven of 17 patients (64.7%) had hepatic dysfunction, mostly cholestasis. The main causes of hepatic dysfunction were loss of enteral feeding and infections. Regarding the complications of the micronutrients, zinc and copper deficiencies have been observed less often because of trace element supplements. However, manganese deposition, especially in the basal ganglia, was recognized in one patient.
Conclusions:
We therefore need to pay more attention to these problems when treating this disease in order to improve the overall prognosis significantly.