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Published on: September 22, 2019
Chronic intestinal failure in children
Michael B Krawinkel1, Dietmar Scholz, Andreas Busch
1Institute of Nutritional Sciences, University of Gießen, Germany. krawinkel@fb09.uni-giessen.de
Insights
Children with chronic intestinal failure (CIF) now have improved life expectancy and quality of life thanks to home parenteral nutrition. Safe nutritional therapy and multidisciplinary monitoring are key to their long-term survival and well-being.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Surgical Innovation
Background:
- Chronic intestinal failure (CIF) in children stems from congenital gut malformations and inflammatory diseases.
- Prevalence of CIF is reported at 13.7 per million population.
- Home parenteral nutrition significantly enhances survival and quality of life for affected children.
Purpose of the Study:
- To review the current management and outcomes of childhood chronic intestinal failure.
- To highlight the importance of multidisciplinary care and nutritional support.
Main Methods:
- Data analysis from a patient registry.
- Selective literature review of relevant publications.
Main Results:
- Children with CIF can now survive beyond adolescence with a good quality of life.
- Early nutritional intervention and close monitoring are crucial for positive outcomes.
- Intestinal transplantation offers a viable treatment option for complex cases.
Conclusions:
- Achieving optimal outcomes in childhood CIF requires safe nutritional therapy and vigilant monitoring by an interdisciplinary team.
- Preventing and treating complications like infections and organ dysfunction is vital.
- Comprehensive support for patients' families, including nursing and social work, is essential.
Background:
Chronic intestinal failure (CIF) in childhood is caused by congenital malformations and inflammatory diseases of the gut. Its reported prevalence is 13.7 per million population. Long-term home parenteral nutrition has dramatically improved the life expectancy and quality of life of children with CIF. The affected children are now treated with parenteral nutrition at home as soon as their medical state and family circumstances allow.
Methods:
The authors present data from a patient registry and review publications retrieved by a selective literature search.
Results And Conclusion:
Children with CIF can now be expected to survive beyond adolescence, at the very least, and enjoy good quality of life. This goal can only be achieved if nutritional therapy is carried out safely and the affected children's development is closely monitored by an interdisciplinary team that consists of primary care physicians/family doctors, neonatologists, pediatric gastroenterologists, and pediatric surgeons. Moreover, the prevention, early detection, and appropriate treatment of complications such as infection, liver disease, renal dysfunction, and disturbances of bone metabolism is of vital importance. The patients' families must be supported by specially qualified ambulatory nurses and social workers. Treatment with parenteral, enteral, and oral nutrition and surgery enables most infants with CIF to meet all their nutritional needs orally by the time they start going to school. For children who suffer from intractable complications, intestinal transplantation provides a real and increasing chance of survival.
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