title: Management of short bowel syndrome in postoperative very low birth weight infants.
abstract: Short bowel syndrome is a potentially devastating morbidity for the very low birth weight infant and family with a high risk for mortality. Prevention of injury to the intestine is the ideal, but, if and when the problem arises, it is important to have a systematic approach to manage nutrition, use pharmaceutical strategies and tools to maximize the outcome potential. Safely maximizing parenteral nutrition support by providing adequate macronutrients and micronutrients while minimizing its hepatotoxic effects is the initial postoperative strategy. As the infant stabilizes and starts to recover from that initial injury and/or surgery, a slow and closely monitored enteral nutrition approach should be initiated. Enteral feeds can be complemented with medications and supplements emerging as valuable clinical tools. Engaging a multidisciplinary team of neonatologists, gastroenterologists, pharmacists, skilled clinical nutrition support staff including registered dietitians and nutrition support nurses will facilitate optimizing each and every infant's long term result. Promoting intestinal rehabilitation and adaptation through evidence-based practice where it is found, and ongoing pursuit of research in this rare and devastating disease, is paramount in achieving optimal outcomes.
authors: Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA. Electronic address: omayer@stanfordchildrens.org.
authors: Olivia
authors: O
authors: Mayer
authors: Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA; Stanford University Medical Center, Stanford, CA, USA.
authors: John A
authors: JA
authors: Kerner
mesh_terms: D004750:Enteral Nutrition; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D010288:Parenteral Nutrition; D012778:Short Bowel Syndrome / Q000178:diet therapy / Q000601:surgery / Q000628:therapy*
keywords: Cholestasis; Enteral nutrition; Human milk; Parenteral nutrition; Parenteral nutrition-associated cholestasis; Short bowel syndrome; Very low birth weight infants