Development of a consensus parenteral solution weaning algorithm for children with short-bowel syndrome associated...

Area of Science:

• Pediatric Gastroenterology
• Intestinal Rehabilitation
• Clinical Algorithm Development

Background:

• Teduglutide, a glucagon-like peptide 2 analogue, effectively reduces parenteral support (PS) needs in pediatric short bowel syndrome-intestinal failure (SBS-IF).
• Current practices for weaning PS in children with SBS-IF on teduglutide lack a clear consensus, leading to variable treatment regimens.
• A need exists for a standardized, real-world approach to PS weaning and patient monitoring.

Purpose of the Study:

• To develop a practical, pediatric-focused algorithm for weaning parenteral support (PS) in children with short bowel syndrome-intestinal failure (SBS-IF) responding to teduglutide.
• To provide a clear, user-friendly guideline for clinicians managing PS reduction in this patient population.
• To facilitate enteral autonomy through optimized PS weaning strategies.

Main Methods:

• A modified Delphi approach was employed to achieve expert consensus.
• Input was gathered from a multidisciplinary team of pediatric clinicians specializing in intestinal rehabilitation.
• The methodology focused on developing a pragmatic and clinically applicable algorithm.

Main Results:

• A user-friendly, pragmatic, and pediatric-focused algorithm for PS weaning in children with SBS-IF has been developed.
• The algorithm provides a structured approach to managing PS reduction in patients responding to teduglutide.
• The developed algorithm is designed for real-world clinical application.

Conclusions:

• The newly developed PS-weaning algorithm offers a practical solution for managing teduglutide-treated children with SBS-IF.
• Further research, including validation studies, is necessary to confirm the algorithm's efficacy and utility.
• The algorithm aims to standardize care and improve outcomes for children requiring intestinal rehabilitation.