A case study utilizing an enteral refeeding technique in a premature infant with short bowel syndrome.
Premature and full-term infants may be born with congenital abnormalities or develop acquired lesions of the gastrointestinal tract that require the placement of an enterostomy. Enterostomies can result in significant segments of excluded small bowel, creating a functional short bowel syndrome. Infants with enterostomies can develop dehydration, electrolyte imbalance, and failure to thrive. An illustrative case report of a premature infant with short bowel syndrome treated with enteral refeedings via a mucous fistula is presented. This report highlights the lessons learned from the interdisciplinary team's collective 10-year experience with enteral refeeding in infants with enterostomies. The physiologic basis for this approach is reviewed and literature reports are outlined. The specific nursing care and step-by-step techniques to deliver enteral refeeding through the mucous fistula are provided along with implications for clinical practice, education, and research.
Gardner
Victoria A
VA
Neonatal Intensive Care Unit, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada. vickiegardner@cogeco.ca
Walton
J Mark
JM
Chessell
Lorraine
L
D000222:Adaptation, Physiological / Q000502:physiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D004750:Enteral Nutrition / Q000379:methods*; D004766:Enterostomy / Q000379:methods*; D041981:Gastrointestinal Tract / Q000033:anatomy & histology / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology / Q000628:therapy*; D017093:Liver Failure / Q000517:prevention & control; D008297:Male; D044342:Malnutrition / Q000503:physiopathology / Q000517:prevention & control; D012778:Short Bowel Syndrome / Q000503:physiopathology / Q000628:therapy*; D054047:Surgical Stomas; D014882:Water-Electrolyte Balance / Q000502:physiology