Refined Multidisciplinary Protocol-Based Approach to Short Bowel Syndrome Improves Outcomes

Journal of Pediatric Gastroenterology and Nutrition
Laura Merras-Salmio, Mikko P Pakarinen

Abstract

Management of short bowel syndrome (SBS) has significantly evolved recently. We present our single-center, 25-year experience focusing on the implementation of a refined multidisciplinary SBS care protocol. This is a retrospective review of the patients with SBS treated at our tertiary center from 1988 to 2014, with either <25% short bowel remaining or duration of parenteral nutrition (PN) >3 months. Patients with primary intestinal motility disorders were excluded. Clinical characteristics, including intestinal anatomy, markers of cholestasis, and catheter-related infections (CRIs), were analyzed. The implementation of a refined modern uniform management protocol in 2009 divided the cohort into 2 subgroups, whose outcomes are compared. Forty-eight patients with SBS were identified (median gestational age 33 weeks). Of them, 22 were born between 2009 and 2014. The main causes of SBS were necrotizing enterocolitis (46%) and midgut volvulus (23%). Median remaining small bowel length was 36 cm. The overall survival was 23 of 26 (88%) before 2009 and 21 of 22 (95%) thereafter, whereas none were transplanted. Duration of PN shortened from a median of 15 to 6 months (P = 0.0015) in the latter cohort, whereas frequency of autologous i...Continue Reading

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Citations

Jun 11, 2015·Liver International : Official Journal of the International Association for the Study of the Liver·Maria HukkinenMikko P Pakarinen
Nov 13, 2015·Journal of Pediatric Surgery·Brenna S FullertonBiren P Modi
Mar 21, 2016·Journal of Pediatric Surgery·Daniel LodwickPeter C Minneci
Sep 1, 2016·Seminars in Fetal & Neonatal Medicine·Olivia Mayer, John A Kerner
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Nov 7, 2016·Surgery·Tomas WesterMikko Pakarinen
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Aug 25, 2017·Journal of Pediatric Gastroenterology and Nutrition·Russell J MerrittUNKNOWN Nutrition Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
Oct 24, 2020·Journal of Pediatric Gastroenterology and Nutrition·Abdalla Kara BallaStuart S Kaufman
May 15, 2020·Journal of Pediatric Gastroenterology and Nutrition·Fanny FredrikssonHelene Engstrand Lilja
May 23, 2020·Clinics in Perinatology·Ethan A MezoffMolly C Dienhart
Mar 19, 2021·JPEN. Journal of Parenteral and Enteral Nutrition·Velarchana SanthanaRiad Rahhal
Jun 22, 2021·The Journal of Pediatrics·Daniela GattiniYaron Avitzur
Jun 26, 2021·The Journal of Surgical Research·Cody J TragesserBrian W Gray
Aug 3, 2021·Journal of Pediatric Gastroenterology and Nutrition·Giovanna VerlatoUNKNOWN European Reference Network on Rare and Inherited Congenital Anomalies (ERNICA)
Oct 26, 2021·Journal of Pediatric Gastroenterology and Nutrition·Sjoerd C J NagelkerkeMerit M Tabbers

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