Successful rehabilitation in pediatric ultrashort small bowel syndrome

Benjamin J. Infantino, David F Mercer, Brandy D. Hobson, Ryan T. Fischer, Brandi K. Gerhardt, Wendy J. Grant, Alan Norman Langnas, Ruben Quiros

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Objective To examine treatment outcomes in pediatric patients with ultrashort small bowel (USSB) syndrome in an intestinal rehabilitation program (IRP). Study design We reviewed IRP records for 2001-2011 and identified 28 children with USSB (≤20 cm of small bowel). We performed univariate analysis using the Fisher exact test and Wilcoxon rank-sum test to compare characteristics of children who achieved parenteral nutrition (PN) independence with intact native bowel and those who did not. Growth, nutritional status, and hepatic laboratory test results were compared from the time of enrollment to the most recent values using the Wilcoxon signed-rank test. Results Of the 28 patients identified, 27 (96%) survived. Almost one-half (48%) of these survivors achieved PN independence with their native bowel. The successfully rehabilitated patients were more likely to have an intact colon and ileocecal valve (P =.01). Significant improvements in PN kcal/kg, total bilirubin, and height and weight z-scores were seen in all patients, but serum hepatic transaminase levels did not improve in the nonrehabilitated patients. Conclusion Enrollment in an IRP provides an excellent probability of survival for children with USSB. The presence of an intact ileocecal valve and colon are positively associated with rehabilitation in this population, but are not requisite. Approximately one-half of patients with USSB can achieve rehabilitation, with a median time to PN independence of less than 2 years. The USSB population can attain reduced PN dependence, improvement of PN-associated liver disease, and enhanced growth with the aid of an IRP.

Original languageEnglish (US)
Pages (from-to)1361-1366
Number of pages6
JournalJournal of Pediatrics
Volume163
Issue number5
DOIs
StatePublished - Nov 1 2013

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Parenteral Nutrition
Rehabilitation
Pediatrics
Nonparametric Statistics
Ileocecal Valve
Colon
Liver
Growth
Transaminases
Nutritional Status
Bilirubin
Population
Survivors
Liver Diseases
Weights and Measures
Survival
Serum

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Infantino, B. J., Mercer, D. F., Hobson, B. D., Fischer, R. T., Gerhardt, B. K., Grant, W. J., ... Quiros, R. (2013). Successful rehabilitation in pediatric ultrashort small bowel syndrome. Journal of Pediatrics, 163(5), 1361-1366. https://doi.org/10.1016/j.jpeds.2013.05.062

Successful rehabilitation in pediatric ultrashort small bowel syndrome. / Infantino, Benjamin J.; Mercer, David F; Hobson, Brandy D.; Fischer, Ryan T.; Gerhardt, Brandi K.; Grant, Wendy J.; Langnas, Alan Norman; Quiros, Ruben.

In: Journal of Pediatrics, Vol. 163, No. 5, 01.11.2013, p. 1361-1366.

Research output: Contribution to journalArticle

Infantino BJ, Mercer DF, Hobson BD, Fischer RT, Gerhardt BK, Grant WJ et al. Successful rehabilitation in pediatric ultrashort small bowel syndrome. Journal of Pediatrics. 2013 Nov 1;163(5):1361-1366. https://doi.org/10.1016/j.jpeds.2013.05.062
Infantino, Benjamin J. ; Mercer, David F ; Hobson, Brandy D. ; Fischer, Ryan T. ; Gerhardt, Brandi K. ; Grant, Wendy J. ; Langnas, Alan Norman ; Quiros, Ruben. / Successful rehabilitation in pediatric ultrashort small bowel syndrome. In: Journal of Pediatrics. 2013 ; Vol. 163, No. 5. pp. 1361-1366.
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