Clinical management of post-pyloric enteral feeding in children.
Post-pyloric feeding (PF) allows the administration of enteral nutrition beyond the pylorus, either into the duodenum or, ideally, into the jejunum. The main indications of PF are: upper gastrointestinal tract obstructions, pancreatic rest (e.g., acute pancreatitis), gastric dysmotility (e.g., critically ill patients and chronic intestinal pseudo-obstruction) or severe gastroesophageal reflux with risk of aspiration (e.g., neurological disability). Physiological and clinical evidence derives from adults, but can also be pertinent to children. This review will discuss the practical management and potential clinical applications of PF in pediatric patients. Some key studies pertaining to the physiological changes during PF will also be considered because they support the strategy of PF management.
Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children's Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy.
Teresa
T
Capriati
Sabrina
S
Cardile
Fabrizio
F
Chiusolo
Filippo
F
Torroni
Paolo
P
Schingo
Domenica
D
Elia
Antonella
A
Diamanti
D002648:Child; D000075202:Contraindications; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D004386:Duodenum; D004750:Enteral Nutrition / Q000009:adverse effects* / Q000379:methods*; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007410:Intestinal Diseases / Q000628:therapy; D007441:Intubation, Gastrointestinal / Q000009:adverse effects* / Q000379:methods*; D007583:Jejunum; D009422:Nervous System Diseases / Q000150:complications; D010179:Pancreas / Q000378:metabolism; D010195:Pancreatitis / Q000628:therapy; D013272:Stomach Diseases / Q000628:therapy
children; duodenal feeding; enteral feeding; enteral nutrition; gastric feeding; jejunal feeding; pancreatic secretion; post-pyloric feeding