Markers of enteral adaptation in pediatric short bowel syndrome

Pediatrics International : Official Journal of the Japan Pediatric Society
Masahiro ChibaAkira Toki

Abstract

The aim of this study was to ascertain if prospective determination of specific gut hormones and growth factors could predict bowel adaptation in children with short bowel syndrome (SBS). We studied independence from parenteral nutrition (PN) as the short-term result and discontinuation of enteral nutrition (EN) as the long-term result from a retrospective chart review of seven patients with SBS, who were managed in the absence of growth retardation. The correlation between increased number of enteral feeds or enteral nutrients and fasting serum gastrin, glucagon-like peptide 2 (GLP-2), citrulline, and D-amino acid oxidase (DAO) activity was analyzed. Five patients were weaned from PN, and two from EN. Fasting serum gastrin was significantly higher and serum GLP-2 lower in the PN-dependent patients than in the patients weaned from EN. The upper limit of fasting serum gastrin for PN independence and for EN independence was 300 and 200 pg/mL, respectively. The lower limit of fasting serum citrulline for PN independence was 15 μmol/L. The relationship between serum citrulline and DAO and the course of bowel adaptation, however, was poor. Serum citrulline is a predictor of PN independence in children with SBS. Fasting serum gastrin...Continue Reading

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Citations

Feb 23, 2019·Expert Review of Gastroenterology & Hepatology·Augusto Lauro, Florence Lacaille
Jan 5, 2021·Pediatric Surgery International·Michael E Höllwarth, Valeria Solari
Oct 21, 2020·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Stefano MaricRaphael Nicolas Vuille-Dit-Bille

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