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Factors associated with enteral autonomy after reanastomosis in infants with intestinal failure and ostomy: A

Arjun D Patel1, Gina Casini2, Joseph L Hagan2

  • 1Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.

JPEN. Journal of Parenteral and Enteral Nutrition
|October 24, 2023
PubMed

Insights

Shorter intestinal discontinuity and earlier enteral nutrition after reanastomosis improve outcomes for infants with intestinal failure and an ostomy. This can lead to higher rates of enteral autonomy and shorter hospital stays.

Area of Science:

  • Pediatric Surgery
  • Neonatology
  • Gastroenterology

Background:

  • Infants with intestinal failure (IF) often require ostomy creation.
  • Reanastomosis (RA) is a critical step in managing these infants.
  • Predictors of successful outcomes after RA are not fully understood.

Purpose of the Study:

  • To identify variables associated with successful outcomes in infants with IF and an ostomy who undergo RA.
  • To analyze the impact of intestinal discontinuity duration and enteral feeding on outcomes.

Main Methods:

  • A single-center, descriptive cohort study included 120 infants with IF and a stoma.
  • Data were collected from January 2011 to December 2020.
  • Penalized logistic and linear regression models were used to analyze outcomes such as enteral autonomy (EA), hospital stay duration, and mortality.

Main Results:

  • Each additional day of intestinal discontinuity decreased the odds of EA by 2% and increased mortality risk by 4.2%.
  • Increased enteral feeds at RA by 1 mL/kg/day raised EA odds by 7.5% and reduced hospital stay by 0.35 days.
  • The median duration between ostomy creation and RA was 80 days.

Conclusions:

  • Minimizing the duration of intestinal discontinuity and initiating enteral nutrition sooner before RA are crucial.
  • These factors positively influence the achievement of enteral autonomy and reduce hospital stay duration in infants with IF and ostomy post-RA.
Abstract

Keywords:
colostomyileostomyintestinal failurejejunostomyostomyshort bowel syndrome

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