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Published on: December 1, 2012
A case study utilizing an enteral refeeding technique in a premature infant with short bowel syndrome
Victoria A Gardner1, J Mark Walton, Lorraine Chessell
1Neonatal Intensive Care Unit, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada. vickiegardner@cogeco.ca
Insights
Enterostomies in infants can cause short bowel syndrome, leading to failure to thrive. This study explores enteral refeeding via a mucous fistula as a treatment for these infants, improving outcomes.
Area of Science:
- Pediatric Gastroenterology
- Neonatology
- Surgical Neonatology
Background:
- Enterostomies are necessary for congenital or acquired gastrointestinal lesions in infants.
- Enterostomies can lead to significant small bowel exclusion, causing functional short bowel syndrome.
- Infants with short bowel syndrome are at risk for dehydration, electrolyte imbalance, and failure to thrive.
Observation:
- A case report details a premature infant with short bowel syndrome treated with enteral refeeding through a mucous fistula.
- The report synthesizes 10 years of interdisciplinary team experience with this treatment approach.
- The physiologic basis for enteral refeeding via mucous fistula is reviewed, along with existing literature.
Findings:
- Enteral refeeding through a mucous fistula can effectively manage short bowel syndrome in infants.
- This approach addresses nutritional deficits and improves overall infant well-being.
- Specific nursing care techniques and step-by-step protocols for mucous fistula feeding are detailed.
Implications:
- This approach offers a viable treatment strategy for infants with enterostomies and short bowel syndrome.
- Clinical practice can be enhanced by implementing standardized enteral refeeding protocols.
- Further research and education are needed to optimize care for these vulnerable infants.
Abstract:
Premature and full-term infants may be born with congenital abnormalities or develop acquired lesions of the gastrointestinal tract that require the placement of an enterostomy. Enterostomies can result in significant segments of excluded small bowel, creating a functional short bowel syndrome. Infants with enterostomies can develop dehydration, electrolyte imbalance, and failure to thrive. An illustrative case report of a premature infant with short bowel syndrome treated with enteral refeedings via a mucous fistula is presented. This report highlights the lessons learned from the interdisciplinary team's collective 10-year experience with enteral refeeding in infants with enterostomies. The physiologic basis for this approach is reviewed and literature reports are outlined. The specific nursing care and step-by-step techniques to deliver enteral refeeding through the mucous fistula are provided along with implications for clinical practice, education, and research.
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