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Achieving Enteral Autonomy in Children with Intestinal Failure Following Inpatient Admission: A Case Series

Allison Fialkowski1, Kathryn Broyles2, Brittany DePaula2

  • 1The Boston Combined Pediatric Residency Program, Boston Children's Hospital and Boston Medical Center, Boston, MA.

The Journal of Pediatrics
|August 2, 2024
PubMed

Insights

Inpatient admission was crucial for children with intestinal failure to achieve enteral autonomy. This approach facilitated weaning from parenteral nutrition through expert care and planning.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Nutrition
  • Intestinal Rehabilitation

Background:

  • Intestinal failure necessitates long-term parenteral nutrition (PN) support.
  • Achieving enteral autonomy is a primary goal in managing pediatric intestinal failure.
  • Transitioning from PN to enteral nutrition requires careful management.

Purpose of the Study:

  • To evaluate the role of inpatient admission in achieving enteral autonomy for children with intestinal failure.
  • To identify key components of inpatient care that facilitate weaning from PN.

Main Methods:

  • Retrospective chart review of 6 children dependent on long-term PN.
  • Analysis of inpatient admission data focusing on interventions and outcomes.
  • Inclusion of feeding and medication titration, interdisciplinary team involvement, and home PN team consultation.

Main Results:

  • Inpatient admission was critical for achieving enteral autonomy in the studied cases.
  • Successful weaning from PN was accomplished following structured inpatient care.
  • Key interventions included precise feeding and medication adjustments.

Conclusions:

  • Inpatient admission provides a structured environment essential for advancing enteral autonomy in pediatric intestinal failure.
  • A multidisciplinary approach during admission, including home PN team consultation, supports successful PN weaning.

Keywords:
dysmotilityenteral autonomyfunctional abdominal paininterdisciplinaryintestinal failureparenteral nutritionshort bowel syndromeweaning

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