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Natural history of pediatric intestinal failure: initial report from the Pediatric Intestinal Failure Consortium.

Publication ,  Journal Article
Squires, RH; Duggan, C; Teitelbaum, DH; Wales, PW; Balint, J; Venick, R; Rhee, S; Sudan, D; Mercer, D; Martinez, JA; Carter, BA; Soden, J ...
Published in: J Pediatr
October 2012

OBJECTIVE: To characterize the natural history of intestinal failure (IF) among 14 pediatric centers during the intestinal transplantation era. STUDY DESIGN: The Pediatric Intestinal Failure Consortium performed a retrospective analysis of clinical and outcome data for a multicenter cohort of infants with IF. Entry criteria included infants <12 months receiving parenteral nutrition (PN) for >60 continuous days. Enteral autonomy was defined as discontinuation of PN for >3 consecutive months. Values are presented as median (25th, 75th percentiles) or as number (%). RESULTS: 272 infants with a gestational age of 34 weeks (30, 36) and birth weight of 2.1 kg (1.2, 2.7) were followed for 25.7 months (11.2, 40.9). Residual small bowel length in 144 patients was 41 cm (25.0, 65.5). Diagnoses were necrotizing enterocolitis (71, 26%), gastroschisis (44, 16%), atresia (27, 10%), volvulus (24, 9%), combinations of these diagnoses (46, 17%), aganglionosis (11, 4%), and other single or multiple diagnoses (48, 18%). Prescribed medications included oral antibiotics (207, 76%), H2 blockers (187, 69%), and proton pump inhibitors (156, 57%). Enteral feeding approaches varied among centers; 19% of the cohort received human milk. The cohort experienced 8.9 new catheter-related blood stream infections per 1000 catheter days. The cumulative incidences for enteral autonomy, death, and intestinal transplantation were 47%, 27%, and 26%, respectively. Enteral autonomy continued into the fifth year after study entry. CONCLUSIONS: Children with IF endure significant mortality and morbidity. Enteral autonomy may require years to achieve. Improved medical, nutritional, and surgical management may reduce time on PN, mortality, and need for transplantation.

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Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

October 2012

Volume

161

Issue

4

Start / End Page

723 / 8.e2

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Prognosis
  • Pediatrics
  • Parenteral Nutrition
  • Male
  • Intestines
  • Intestinal Volvulus
  • Intestinal Diseases
  • Intestinal Atresia
  • Infant
 

Citation

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Squires, R. H., Duggan, C., Teitelbaum, D. H., Wales, P. W., Balint, J., Venick, R., … Pediatric Intestinal Failure Consortium, . (2012). Natural history of pediatric intestinal failure: initial report from the Pediatric Intestinal Failure Consortium. J Pediatr, 161(4), 723-8.e2. https://doi.org/10.1016/j.jpeds.2012.03.062
Squires, Robert H., Christopher Duggan, Daniel H. Teitelbaum, Paul W. Wales, Jane Balint, Robert Venick, Susan Rhee, et al. “Natural history of pediatric intestinal failure: initial report from the Pediatric Intestinal Failure Consortium.J Pediatr 161, no. 4 (October 2012): 723-8.e2. https://doi.org/10.1016/j.jpeds.2012.03.062.
Squires RH, Duggan C, Teitelbaum DH, Wales PW, Balint J, Venick R, et al. Natural history of pediatric intestinal failure: initial report from the Pediatric Intestinal Failure Consortium. J Pediatr. 2012 Oct;161(4):723-8.e2.
Squires, Robert H., et al. “Natural history of pediatric intestinal failure: initial report from the Pediatric Intestinal Failure Consortium.J Pediatr, vol. 161, no. 4, Oct. 2012, pp. 723-8.e2. Pubmed, doi:10.1016/j.jpeds.2012.03.062.
Squires RH, Duggan C, Teitelbaum DH, Wales PW, Balint J, Venick R, Rhee S, Sudan D, Mercer D, Martinez JA, Carter BA, Soden J, Horslen S, Rudolph JA, Kocoshis S, Superina R, Lawlor S, Haller T, Kurs-Lasky M, Belle SH, Pediatric Intestinal Failure Consortium. Natural history of pediatric intestinal failure: initial report from the Pediatric Intestinal Failure Consortium. J Pediatr. 2012 Oct;161(4):723–8.e2.
Journal cover image

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

October 2012

Volume

161

Issue

4

Start / End Page

723 / 8.e2

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Prognosis
  • Pediatrics
  • Parenteral Nutrition
  • Male
  • Intestines
  • Intestinal Volvulus
  • Intestinal Diseases
  • Intestinal Atresia
  • Infant