Adv Pediatr Surg.  2020 Dec;26(2):61-66. 10.13029/aps.2020.26.2.61.

Multidisciplinary Intestinal Rehabilitation in Children: Results from a Korean Intestinal Rehabilitation Team

• Lee C
• Lee S
• Park HJ
• Kim HJ
• Min JK
• Seo JM

• KMID: 2525501
• DOI: http://doi.org/10.13029/aps.2020.26.2.61

Abstract

Purpose
Intense multidisciplinary team effort is required for the intestinal rehabilitation of pediatric patients afflicted with intestinal failure (IF). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation.
Methods
In the intestinal rehabilitation team (IRT) at our center, we have experienced 25 cases of pediatric IF requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records.
Results
Of the 25 subjects treated, 18 were boys and 7 were girls. At the time of referral to the IRT, the mean age was 1.6 years. Median follow-up was 42.9 months. The causes of IF were short bowel syndrome in 18 cases and motility-related in 7 cases. There are 24 patients alive at last follow-up: 12 patients have been weaned off PN, whereas 12 are still dependent on PN. Median time to weaning off PN was 4.8 months. There were 2 cases of IF-associated liver disease. Fifteen cases of central line associated blood stream infections occurred in 9 patients (0.82/1,000 PN days).
Conclusion
We report the results of multidisciplinary intestinal rehabilitation of pediatric IF patients in a Korean IRT. Further studies are required to improve survival and enteral tolerance of these patients.

Keyword

Short bowel syndrome; Intestinal rehabilitation; Parenteral nutrition; Intestinal failure-associated liver disease; Central line-associated blood stream infection