A 10 YEARS SBS RETROSPECTIVE STUDY OF NEONATES AND CHILDREN

摘要

Introduction: Short bowel syndrome (SBS) neonates have complex management challenges, meaning a significant health care extra cost. This is 10 years retrospective SBS study-based estimate of children and neonates in our hospital. Population estimate of the incidence and mortality rate of neonates with SBS is not so accurate because of the differences in the definition, followup and regional referral patterns. The introduction of total parenteral nutrition (TPN) led to a remarkable improvement in the survival of SBS patients, but unfortunately the most common cause of death in SBS patient`s is also TPNinduced hepatic dysfunction. Even though the survival of patients with less than or equal to 40 cm of residual small bowel is now routine. The long term survival of infants with as little as 20 to 30 cm small bowel can be expected. The management goal of these patients is to reduce the duration of TPN and to maximize intestinal nutrient absorption. It is difficult to predict the duration and the type of nutritional support for patients with SBS. Some patients may require permanent parenteral nutrition on either a continuous or intermittent basis depending on the length of the residual bowel. Objective: To evaluate the direct and indirect evidence that adaptation occurs after an extensive bowel resection, to review the factors that influence adaptation and to assess the strategies used in attempts to optimize this process. Methodology: A retrospective medical record review of newborns and children with SBS treated at our hospital between 2007 and 2017. Medical records of patients studied were retrieved from our archives and analyzed. Results: a p-value less than 0.05 (p-value = 0.033) was obtained, being statistically significant proving that there is a direct correlation between the post-operation intestinal length and the duration of parenteral nutrition. Conclusion: The major predictors of weaning from PN are adjusted small bowel length and the amount of energy patient can derive from enteral feeding attempts, also as a result of new management strategies combined with a multidisciplinary team approach, majority of patients will wean from PN despite short intestinal length.