Abstract
Perhaps in no other pathophysiological state in infancy are the tenets of nutritional management more thought provoking as they are in intestinal failure therapy. Intestinal failure is the critical reduction of functional gut mass below the minimal amount necessary for adequate digestion and absorption to satisfy body nutrient and fluid requirements in adults or growth in children [1]. This definition implies an absolute requirement for parenteral nutrition in order to sustain viability. The unique aspects of management in this population of patients is derived from the variability of individual physiologic states, the chronicity in which parenteral nutrition must be administered, the therapeutic implications of enteral nutrients, and the complications directly linked to nutritional therapy. The goal of this chapter is to outline the nutritional aspects of intestinal failure management highlighting the specific aspects that make it such a challenging condition.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Thompson JS. Overview of etiology and management of intestinal failure. Gastroenterology. 2006;130(2 Suppl 1): S3–4.
Nucci A, Burns RC, Armah T, et al. Interdisciplinary management of pediatric intestinal failure: a 10-year review of rehabilitation and transplantation. J Gastrointest Surg. 2008;12(3):429–35. discussion 435–426.
Goulet O, Baglin-Gobet S, Talbotec C, et al. Outcome and long-term growth after extensive small bowel resection in the neonatal period: a survey of 87 children. Eur J Pediatr Surg. 2005;15(2):95–101.
Quiros-Tejeira RE, Ament ME, Reyen L, et al. Long-term parenteral nutritional support and intestinal adaptation in children with short bowel syndrome: a 25-year experience. J Pediatr. 2004;145(2):157–63.
Sherry B, Mei Z, Grummer-Strawn L, Dietz WH. Evaluation of and recommendations for growth references for very low birth weight (< or =1500 grams) infants in the United States. Pediatrics. 2003;111(4 Pt 1):750–8.
Cronk C, Crocker AC, Pueschel SM, et al. Growth charts for children with Down syndrome: 1 month to 18 years of age. Pediatrics. 1988;81(1):102–10.
Dalieri M, Fabeiro M, Prozzi M, et al. Growth assessment of children with neonatal short bowel syndrome (SBS). Nutr Hosp. 2007;22(4):455–60.
Olieman JF, Penning C, Spoel M, et al. Long-term impact of infantile short bowel syndrome on nutritional status and growth. Br J Nutr. 2011;15:1–9.
Williamson RC, Buchholtz TW, Malt RA. Humoral stimulation of cell proliferation in small bowel after transection and resection in rats. Gastroenterology. 1978;75(2):249–54.
Sigalet DL, Martin GR, Butzner JD, Buret A, Meddings JB. A pilot study of the use of epidermal growth factor in pediatric short bowel syndrome. J Pediatr Surg. 2005;40(5):763–8.
Byrne TA, Morrissey TB, Nattakom TV, Ziegler TR, Wilmore DW. Growth hormone, glutamine, and a modified diet enhance nutrient absorption in patients with severe short bowel syndrome. JPEN J Parenter Enteral Nutr. 1995;19(4):296–302.
Scolapio JS. Effect of growth hormone, glutamine, and diet on body composition in short bowel syndrome: a randomized, controlled study. JPEN J Parenter Enteral Nutr. 1999;23(6):309–12. discussion 312–303.
Jeppesen PB, Gilroy R, Pertkiewicz M, Allard JP, Messing B, O’Keefe SJ. Randomised placebo-controlled trial of teduglutide in reducing parenteral nutrition and/or intravenous fluid requirements in patients with short bowel syndrome. Gut. 2011;60(7):902–14.
Orenstein SR. Enteral versus parenteral therapy for intractable diarrhea of infancy: a prospective, randomized trial. J Pediatr. 1986;109(2):277–86.
Javid PJ, Collier S, Richardson D, et al. The role of enteral nutrition in the reversal of parenteral nutrition-associated liver dysfunction in infants. J Pediatr Surg. 2005;40(6):1015–8.
Joly F, Dray X, Corcos O, Barbot L, Kapel N, Messing B. Tube feeding improves intestinal absorption in short bowel syndrome patients. Gastroenterology. 2009;136(3):824–31.
Warner BB, Ryan AL, Seeger K, Leonard AC, Erwin CR, Warner BW. Ontogeny of salivary epidermal growth factor and necrotizing enterocolitis. J Pediatr. 2007;150(4):358–63.
Andorsky DJ, Lund DP, Lillehei CW, et al. Nutritional and other postoperative management of neonates with short bowel syndrome correlates with clinical outcomes. J Pediatr. 2001;139(1):27–33.
Dvorak B. Milk epidermal growth factor and gut protection. J Pediatr. 2010;156(2 Suppl):S31–5.
DiBaise JK, Young RJ, Vanderhoof JA. Intestinal rehabilitation and the short bowel syndrome: part 1. Am J Gastroenterol. 2004;99(7):1386–95.
Weser E, Babbitt J, Hoban M, Vandeventer A. Intestinal adaptation. Different growth responses to disaccharides compared with monosaccharides in rat small bowel. Gastroenterology. 1986;91(6):1521–7.
Vanderhoof JA, Grandjean CJ, Burkley KT, Antonson DL. Effect of casein versus casein hydrolysate on mucosal adaptation following massive bowel resection in infant rats. J Pediatr Gastroenterol Nutr. 1984;3(2):262–7.
Vanderhoof JA, Grandjean CJ, Kaufman SS, Burkley KT, Antonson DL. Effect of high percentage medium-chain triglyceride diet on mucosal adaptation following massive bowel resection in rats. JPEN J Parenter Enteral Nutr. 1984;8(6):685–9.
Bines J, Francis D, Hill D. Reducing parenteral requirement in children with short bowel syndrome: impact of an amino acid-based complete infant formula. J Pediatr Gastroenterol Nutr. 1998;26(2):123–8.
Crenn P, Morin MC, Joly F, Penven S, Thuillier F, Messing B. Net digestive absorption and adaptive hyperphagia in adult short bowel patients. Gut. 2004;53(9):1279–86.
Wessel JJ, Kocoshis SA. Nutritional management of infants with short bowel syndrome. Semin Perinatol. 2007;31(2):104–11.
Miller AJ. The neurobiology of swallowing and dysphagia. Dev Disabil Res Rev. 2008;14(2):77–86.
Olieman JF, Penning C, Ijsselstijn H, et al. Enteral nutrition in children with short-bowel syndrome: current evidence and recommendations for the clinician. J Am Diet Assoc. 2010;110(3):420–6.
Drenckpohl D, Hocker J, Shareef M, Vegunta R, Colgan C. Adding dietary green beans resolves the diarrhea associated with bowel surgery in neonates: a case study. Nutr Clin Pract. 2005;20(6):674–7.
Hellerstein S. Fluid and electrolytes: clinical aspects. Pediatr Rev. 1993;14(3):103–15.
Schwarz KB, Ternberg JL, Bell MJ, Keating JP. Sodium needs of infants and children with ileostomy. J Pediatr. 1983;102(4):509–13.
Bower TR, Pringle KC, Soper RT. Sodium deficit causing decreased weight gain and metabolic acidosis in infants with ileostomy. J Pediatr Surg. 1988;23(6):567–72.
Baker ML, Williams RN, Nightingale JM. Causes and management of a high-output stoma. Colorectal Dis. 2011;13(2):191–7.
Suh SM, Tashjian Jr AH, Matsuo N, Parkinson DK, Fraser D. Pathogenesis of hypocalcemia in primary hypomagnesemia: normal end-organ responsiveness to parathyroid hormone, impaired parathyroid gland function. J Clin Invest. 1973;52(1):153–60.
Perlmutter DH, Boyle JT, Campos JM, Egler JM, Watkins JB. D-Lactic acidosis in children: an unusual metabolic complication of small bowel resection. J Pediatr. 1983;102(2):234–8.
Yang CF, Duro D, Zurakowski D, Lee M, Jaksic T, Duggan C. High prevalence of multiple micronutrient deficiencies in children with intestinal failure: a longitudinal study. J Pediatr. 2011;159(1):39–44. e31.
Greene HL, Hambidge KM, Schanler R, Tsang RC. Guidelines for the use of vitamins, trace elements, calcium, magnesium, and phosphorus in infants and children receiving total parenteral nutrition: report of the Subcommittee on Pediatric Parenteral Nutrient Requirements from the Committee on Clinical Practice Issues of the American Society for Clinical Nutrition. Am J Clin Nutr. 1988;48(5):1324–42.
Mikalunas V, Fitzgerald K, Rubin H, McCarthy R, Craig RM. Abnormal vitamin levels in patients receiving home total parenteral nutrition. J Clin Gastroenterol. 2001;33(5):393–6.
Muwakkit S, Al-Aridi C, Saab R, Hourani R, Yazbeck N, Abboud M. Wernicke’s encephalopathy during total parenteral nutrition in a child with acute lymphoblastic leukemia and acute pancreatitis. Neuropediatrics. 2009;40(5):249–51.
Slicker J, Vermilyea S. Pediatric parenteral nutrition: putting the microscope on macronutrients and micronutrients. Nutr Clin Pract. 2009;24(4):481–6.
Frem J, Sarson Y, Sternberg T, Cole CR. Copper supplementation in parenteral nutrition of cholestatic infants. J Pediatr Gastroenterol Nutr. 2010;50(6):650–4.
Moukarzel A. Chromium in parenteral nutrition: too little or too much? Gastroenterology. 2009;137(5 Suppl):S18–28.
Hardy G. Manganese in parenteral nutrition: who, when, and why should we supplement? Gastroenterology. 2009;137(5 Suppl):S29–35.
Masumoto K, Nagata K, Higashi M, et al. Clinical features of selenium deficiency in infants receiving long-term nutritional support. Nutrition. 2007;23(11–12):782–7.
Cairns PA, Stalker DJ. Carnitine supplementation of parenterally fed neonates. Cochrane Database Syst Rev. 2000;(4):CD000950.
Khaodhiar L, Keane-Ellison M, Tawa NE, Thibault A, Burke PA, Bistrian BR. Iron deficiency anemia in patients receiving home total parenteral nutrition. JPEN J Parenter Enteral Nutr. 2002;26(2):114–9.
Nose O, Tipton JR, Ament ME, Yabuuchi H. Effect of the energy source on changes in energy expenditure, respiratory quotient, and nitrogen balance during total parenteral nutrition in children. Pediatr Res. 1987;21(6):538–41.
Lloyd DA, Gabe SM. Managing liver dysfunction in parenteral nutrition. Proc Nutr Soc. 2007;66(4):530–8.
Beltrand J, Colomb V, Marinier E, et al. Lower insulin secretory response to glucose induced by artificial nutrition in children: prolonged and total parenteral nutrition. Pediatr Res. 2007;62(5):624–9.
Bendorf K, Friesen CA, Roberts CC. Glucose response to discontinuation of parenteral nutrition in patients less than 3 years of age. JPEN J Parenter Enteral Nutr. 1996;20(2):120–2.
Mirtallo J, Canada T, Johnson D, et al. Safe practices for parenteral nutrition. JPEN J Parenter Enteral Nutr. 2004;28(6):S39–70.
Iyer KR, Spitz L, Clayton P. BAPS prize lecture: New insight into mechanisms of parenteral nutrition-associated cholestasis: role of plant sterols. British Association of Paediatric Surgeons. J Pediatr Surg. 1998;33(1):1–6.
Clayton PT, Whitfield P, Iyer K. The role of phytosterols in the pathogenesis of liver complications of pediatric parenteral nutrition. Nutrition. 1998;14(1):158–64.
Carter BA, Taylor OA, Prendergast DR, et al. Stigmasterol, a soy lipid-derived phytosterol, is an antagonist of the bile acid nuclear receptor FXR. Pediatr Res. 2007;62(3):301–6.
Cober MP, Teitelbaum DH. Prevention of parenteral nutrition-associated liver disease: lipid minimization. Curr Opin Organ Transplant. 2010;15(3):330–3.
Puder M, Valim C, Meisel JA, et al. Parenteral fish oil improves outcomes in patients with parenteral nutrition-associated liver injury. Ann Surg. 2009;250(3):395–402.
Goulet O, Joly F, Corriol O, Colomb-Jung V. Some new insights in intestinal failure-associated liver disease. Curr Opin Organ Transplant. 2009;14(3):256–61.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Rudolph, J.A. (2013). The Nutritional Aspects of Intestinal Failure Therapy. In: Watson, R., Grimble, G., Preedy, V., Zibadi, S. (eds) Nutrition in Infancy. Nutrition and Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-254-4_12
Download citation
DOI: https://doi.org/10.1007/978-1-62703-254-4_12
Published:
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-62703-253-7
Online ISBN: 978-1-62703-254-4
eBook Packages: MedicineMedicine (R0)