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[Long-term TPN for short bowel syndrome]
S Yokoyama1, T Fujimoto, T Mitomi
1Department of Surgery, Tokai University, School of Medicine, Isehara, Japan.
Nihon Geka Gakkai Zasshi
|September 1, 1988
Summary
Total parenteral nutrition (TPN) in infants with extremely short bowel is crucial but carries risks like catheter sepsis and liver dysfunction. Early oral feeding alongside TPN can mitigate complications.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Intensive Care
Context:
- Total parenteral nutrition (TPN) is a life-sustaining treatment for infants with extremely short bowel.
- Management of these infants presents significant challenges, including high risks of complications.
Purpose:
- To evaluate the role and safety of TPN in managing infants with extremely short bowel.
- To assess TPN-related complications, including catheter sepsis and hepatic dysfunction.
Summary:
- The study included 163 children receiving TPN, with 7 cases of short bowel syndrome.
- Mortality rate was 3% (5/163), primarily due to catheter sepsis.
- Broviac catheters showed significantly fewer complications than conventional Silastic catheters (p<0.01).
- Hepatic dysfunction was a notable complication, often resolving with the initiation of enteral feeding.
- Early oral feeding, supported by TPN, is recommended to manage fluid loss and improve outcomes.
- Rare complications like copper deficiency and urolithiasis were also reported.
Impact:
- Highlights the critical role of TPN in extremely short bowel syndrome while underscoring the need for vigilant monitoring.
- Demonstrates the superiority of Broviac catheters in reducing central venous catheter-related sepsis.
- Emphasizes the importance of early enteral nutrition alongside TPN for managing short bowel syndrome and associated complications.