The experience of a regional pediatric intestinal failure program: Successful outcomes from intestinal rehabilitation.
BACKGROUND
The aim of this study was to evaluate the clinical experience of a regional multidisciplinary intestinal failure program for children established in 2005.


METHODS
Data were collected from a prospective internal database. Univariate analyses were performed to compare pre- and post-treatment outcomes. Median values are reported.


RESULTS
Forty-nine children were referred at an age of 7 months. Remnant small bowel length was 29 cm. With follow-up of 14 months, overall patient survival was 88%. Thirteen bowel-lengthening procedures were performed, thereby increasing small bowel length from 83 to 132 cm (P < .05). Enteral autonomy was achieved in 22 patients (45%), and the caloric requirement for parenteral nutrition was decreased from 100% to 41% (P < .01). Conjugated bilirubin was reduced from 4.1 to 0 mg/dL (P < .05).


CONCLUSIONS
A multidisciplinary approach to pediatric intestinal failure that prioritizes intestinal rehabilitation can achieve successful enteral feeding advancement, improved liver function, and excellent survival in intermediate-range follow-up.
Javid
Patrick J
PJ
Division of Pediatric General and Thoracic Surgery, Seattle Children's Hospital, Seattle, WA, USA. patrick.javid@seattlechildrens.org
Malone
Frances R
FR
Reyes
Jorge
J
Healey
Patrick J
PJ
Horslen
Simon P
SP
D000704:Analysis of Variance; D002423:Cause of Death; D016208:Databases, Factual; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery* / Q000637:transplantation; D008297:Male; D010288:Parenteral Nutrition / Q000379:methods; D010348:Patient Care Team / Q000458:organization & administration; D011183:Postoperative Complications / Q000401:mortality / Q000534:rehabilitation; D011336:Probability; D015397:Program Evaluation; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012778:Short Bowel Syndrome / Q000175:diagnosis / Q000401:mortality* / Q000534:rehabilitation*; D016019:Survival Analysis; D016896:Treatment Outcome