Exploration of home nutrition support in children with intestinal failure and clinical experience with 10 cases
10.3760/cma.j.cn115822-20210417-00089
- VernacularTitle:小儿肠衰竭实施家庭营养支持探索十例临床分析
- Author:
Yiqing CHU
1
;
Haixia FENG
;
Yijing TAO
;
Lina LU
;
Weihui YAN
;
Ying WANG
;
Wei CAI
Author Information
1. 上海交通大学医学院附属新华医院小儿消化营养科 200092
- Keywords:
Pediatric;
Intestinal failure;
Home nutrition support;
Home parenteral nutrition;
Home enteral nutrition;
Nutrition support team
- From:
Chinese Journal of Clinical Nutrition
2021;29(4):226-231
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application of home nutrition support in children with intestinal failure.Methods:Children with intestinal failure admitted to Division of Pediatric Gastroenterology and Nutrition and Department of Pediatric Surgery in Xinhua Hospital were retrospectively enrolled since January 2009. The details of home nutrition support, nutritional status and home parenteral nutrition (HPN) associated complications were collected.Results:A total of 10 children received HPN support, 7 of whom were with short bowel syndrome (SBS) and the other 3 with pediatric intestinal pseudo-obstruction. The average length of remnant small bowel in 7 SBS children was (36.7±32.4) cm. The average age at HPN onset was (5.4±4.7) years. The average duration of follow-up was (3.1±2.1) years. The average duration of HPN was (619.5±669.1) days after (391.8±340.1) days of parenteral nutrition support in our hospital. All 10 cases started home enteral nutrition (HEN) with tube feeding (3 cases transited to oral feeding during treatment). The average duration of HEN was (536.1±429.6) days. Daily calorie intake was 104.0%±39.0% of the recommended intake according to the guideline, with 46.5%±21.3% via HPN and 57.5%±29.2% via HEN. During follow-up, 3 cases were found with severe malnutrition, 5 with moderate malnutrition and 2 with mild malnutrition. Four children suffered from catheter-related thrombosis and five children were identified with catheter-related blood stream infection. No intestinal failure associated liver disease was observed.Conclusions:HPN is feasible but needs the support of national medical insurance policy. At present, there are still frequent nutritional deficiencies and complications in HPN. Nutrition support team (NST) should provide guidance for more scientific nutrition screening and nutrition management.
