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Chyme reinfusion practices in the neonatal population
Alexandria H Lim1, Georges Tinawi2, Taylor Harrington3,4
1Department of Surgery, The University of Auckland, Auckland, New Zealand. alexandriahl84@gmail.com.
Pediatric Surgery International
|November 27, 2024
Summary
Chyme reinfusion therapy (CRT) improves neonatal nutrition and intestinal adaptation. This underutilized practice shows promise for infants with bowel anomalies or necrotizing enterocolitis, despite some non-CRT-related complications.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Surgical Nutrition
Background:
- Chyme reinfusion therapy (CRT) is a method to refeed proximal stoma output into the distal bowel, promoting intestinal adaptation.
- While effective, CRT is underutilized in neonates, particularly those with congenital bowel anomalies or necrotizing enterocolitis.
Purpose of the Study:
- To determine the frequency, methodology, and adverse effects of CRT in a neonatal population.
- To evaluate the impact of CRT on nutritional outcomes and intestinal adaptation in neonates.
Main Methods:
- A ten-year retrospective cohort study was conducted across two major pediatric hospitals in New Zealand.
- Data were collected on eligible neonates undergoing CRT, focusing on methodology and outcomes.
Main Results:
- Of 49 eligible neonates, 23 (47%) received CRT for indications like high stoma output and malnutrition.
- CRT was associated with a significant increase in median daily weight gain (13.9 to 24.37 g/day, p=0.04).
- Non-infectious complications such as peri-stomal skin irritation (60%) and stoma prolapse (43%) were common, but few were directly related to CRT.
Conclusions:
- Chyme reinfusion therapy is an underutilized yet effective method for improving nutrition in neonates with intestinal failure.
- Standardized protocols are needed to promote consistent CRT utilization and optimize outcomes for high-risk neonates.
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