Etiology and Medical Management of Pediatric Intestinal Failure

Gastroenterol Clin North Am. 2019 Dec;48(4):483-498. doi: 10.1016/j.gtc.2019.08.003. Epub 2019 Oct 4.

Abstract

Pediatric intestinal failure occurs when gut function is insufficient to meet the growing child's hydration and nutrition needs. After massive bowel resection, the remnant bowel adapts to lost absorptive and digestive capacity through incompletely defined mechanisms newly targeted for pharmacologic augmentation. Management seeks to achieve enteral autonomy and mitigate the development of comorbid disease. Care has improved, most notably related to reductions in blood stream infection and liver disease. The future likely holds expansion of pharmacologic adaptation augmentation, refinement of intestinal tissue engineering techniques, and the development of a learning health network for efficient multicenter study and care improvement.

Keywords: Parenteral nutrition; Pediatric intestinal failure; Short bowel syndrome.

Publication types

  • Review

MeSH terms

  • Adaptation, Physiological
  • Avitaminosis / etiology
  • Avitaminosis / therapy
  • Catheterization, Central Venous / adverse effects
  • Child
  • Endoscopy, Digestive System
  • Enteral Nutrition
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Liver Diseases / etiology
  • Liver Diseases / therapy
  • Micronutrients / deficiency
  • Parenteral Nutrition
  • Patient Care Team
  • Short Bowel Syndrome / etiology
  • Short Bowel Syndrome / therapy*

Substances

  • Gastrointestinal Agents
  • Micronutrients