Approach to Intestinal Failure in Children

Curr Gastroenterol Rep. 2021 Apr 15;23(6):8. doi: 10.1007/s11894-021-00807-4.

Abstract

Purpose of review: Pediatric intestinal failure is a complex condition requiring specialized care to prevent potential complications. In this article, we review the available evidence supporting recent advances in care for children with intestinal failure.

Recent findings: Multidisciplinary intestinal rehabilitation teams utilize medical and surgical management techniques to help patients achieve enteral autonomy (EA) while preventing and treating the complications associated with intestinal failure. Recent advances in lipid management strategies, minimization of intestinal failure associated liver disease, prevention of central line-associated blood stream infections, and loss of access, as well as development of promising new hormone analogue therapy have allowed promotion of intestinal adaptation. These advances have decreased the need for intestinal transplant. There have been recent advances in the care of children with intestinal failure decreasing morbidity, mortality, and need for intestinal transplantation. The most promising new therapies involve replacement of enteroendocrine hormones.

Keywords: Central venous access; Intestinal failure associated liver disease; Intestinal rehabilitation; Intestinal transplant; Parenteral nutrition; Teduglutide.

Publication types

  • Review

MeSH terms

  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / methods
  • Child
  • Chronic Disease
  • Enteral Nutrition*
  • Fat Emulsions, Intravenous / administration & dosage
  • Hormones / therapeutic use
  • Humans
  • Intestinal Diseases / diagnosis
  • Intestinal Diseases / etiology
  • Intestinal Diseases / rehabilitation
  • Intestinal Diseases / therapy*
  • Intestinal Pseudo-Obstruction / diagnosis
  • Intestinal Pseudo-Obstruction / etiology
  • Intestinal Pseudo-Obstruction / rehabilitation
  • Intestinal Pseudo-Obstruction / therapy
  • Intestines / transplantation
  • Organ Transplantation
  • Parenteral Nutrition
  • Short Bowel Syndrome / diagnosis
  • Short Bowel Syndrome / etiology
  • Short Bowel Syndrome / rehabilitation
  • Short Bowel Syndrome / therapy*

Substances

  • Fat Emulsions, Intravenous
  • Hormones