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Intestinal failure: the evolving demographic and patient outcomes on home parenteral nutrition

Sarah Kate Brown1, Natalie Davies2, Enda Smyth1

  • 1Department of Paediatric Gastroenterology, University Hospitals Southampton NHS Trust, Southampton, UK.

Acta Paediatrica (Oslo, Norway : 1992)
|May 14, 2018
PubMed

Insights

Outcomes for children on home parenteral nutrition (HPN) have improved, with lower infection and liver disease rates. However, increasing cases of neuromuscular disease (NMD) present a growing healthcare challenge.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Nutrition
  • Healthcare Delivery

Background:

  • Intestinal failure (IF) impacts children requiring home parenteral nutrition (HPN).
  • Understanding evolving demographics and outcomes is crucial for effective healthcare planning.

Purpose of the Study:

  • To examine the changing demographics of pediatric intestinal failure.
  • To analyze the trends in outcomes for children receiving home parenteral nutrition.
  • To assess the implications for healthcare delivery and intestinal rehabilitation services.

Main Methods:

  • Retrospective analysis of outcome data for children on HPN over a 15-year period.
  • Data included patient demographics, etiology of IF, and key clinical outcomes.

Main Results:

  • HPN prevalence increased significantly from 2000 to 2016.
  • Outcomes improved over time, with reduced rates of catheter-related bloodstream infection (CRBSI) and intestinal failure-associated liver disease (IFALD).
  • Neuromuscular disease (NMD) emerged as a leading cause of IF, associated with higher rates of IFALD, CRBSI, and mortality compared to short bowel syndrome (SBS).

Conclusions:

  • Long-term parenteral nutrition outcomes have improved.
  • The rising incidence of NMD in IF patients increases the overall healthcare burden.
  • Intestinal rehabilitation services must adapt to the changing patient profile, particularly those with NMD.
Abstract

Keywords:
Intestinal motility disturbancesNeonatal gastrointestinal surgeryParenteral nutritionShort gut syndrome

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