Management of short bowel syndrome in postoperative very low birth weight infants

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• 作者：Olivia Mayer^a ; ^{omayer@stanfordchildrens.org} ; John A. Kerner^a ; ^b
• 关键词：Very low birth weight infants ; Parenteral nutrition ; Short bowel syndrome ; Enteral nutrition ; Human milk ; Cholestasis ; Parenteral nutrition-associated cholestasis
• 刊名：Seminars in Fetal and Neonatal Medicine
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：22
• 期：1
• 页码：49-56
• 全文大小：1287 K
• 卷排序：22

文摘

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.