Natural history of pediatric intestinal failure: initial report from the Pediatric Intestinal Failure Consortium.
Natural history of pediatric intestinal failure: initial report from the Pediatric Intestinal Failure Consortium.
复制标题
DOI：
10.1016/j.jpeds.2012.03.062
复制
发表时间：
2012-10
影响因子：
5.1
通讯作者：
Belle, Steven H.
中科院分区：
文献类型：
--
作者：
Squires, Robert H.;Duggan, Christopher;Teitelbaum, Daniel H.;Wales, Paul W.;Balint, Jane;Venick, Robert;Rhee, Susan;Sudan, Debra;Mercer, David;Martinez, J. Andres;Carter, Beth A.;Soden, Jason;Horslen, Simon;Rudolph, Jeffrey A.;Kocoshis, Samuel;Superina, Riccardo;Lawlor, Sharon;Haller, Tamara;Kurs-Lasky, Marcia;Belle, Steven H.
描述肠道移植 (ITx) 时代 14 个儿科中心肠衰竭 (IF) 的自然史。儿科肠衰竭联盟对多中心 IF 婴儿队列的临床和结果数据进行了回顾性分析。入选标准包括<12个月的婴儿连续接受肠外营养(PN)>60天。肠内自主定义为连续 3 个月以上停止 PN。值以中位数（第 25 个、第 75 个百分位数）或（n、%）表示。对 272 名胎龄 34 周、出生体重 2.1 kg (1.2, 2.7) 的婴儿进行了为期 25.7 个月 (11.2, 40.9) 的随访。 144 名患者的残余小肠长度为 41 cm (25.0, 65.5)。诊断为坏死性小肠结肠炎 (71, 26%)、腹裂 (44, 16%)、闭锁 (27, 10%)、肠扭转 (24, 9%)、这些诊断的组合 (46, 17%)、无神经节病 (11, 4%) 和其他单一或多重诊断 (48, 18%)。处方药物包括口服抗生素（207 种，76%）、H2 阻滞剂（187 种，69%）和质子泵抑制剂（156 种，57%）。不同中心的肠内喂养方法各不相同； 19% 的人群接受母乳。该队列每 1,000 个导管日发生 8.9 例新的导管相关血流感染。肠内自主、死亡和ITx的累积发生率分别为47%、27%和26%。肠内自主权持续到进入研究后的第五年。患有 IF 的儿童死亡率和发病率很高。肠内自主可能需要数年时间才能实现。改善医疗、营养和手术管理可能会减少 PN 时间、死亡率和移植需求。
To characterize the natural history of intestinal failure (IF) among 14 pediatric centers during the intestinal transplantation (ITx) era. The Pediatric Intestinal Failure Consortium performed a retrospective analysis of clinical and outcome data for a multi-center cohort of infants with IF. Entry criteria included infants <12 mo receiving parenteral nutrition (PN) for >60 continuous days. Enteral autonomy was defined as discontinuation of PN for >3 consecutive months. Values are presented as median (25th, 75th percentiles) or as (n, %). 272 infants with a gestational age of 34 wks and birth weight of 2.1 kg (1.2, 2.7) were followed for 25.7 mo (11.2, 40.9). Residual small bowel length in 144 patients was 41 cm (25.0, 65.5). Diagnoses were necrotizing enterocolitis (71, 26%), gastroschisis (44, 16%), atresia (27, 10%), volvulus (24, 9%), combinations of these diagnoses (46, 17%), aganglionosis (11, 4%), and other single or multiple diagnoses (48, 18%). Prescribed medications included oral antibiotics (207, 76%), H2 blockers (187, 69%), and PPIs (156, 57%). Enteral feeding approaches varied among centers; 19% of the cohort received human milk. The cohort experienced 8.9 new catheter-related blood stream infections per 1,000 catheter days. The cumulative incidences for enteral autonomy, death, and ITx were 47%, 27%, and 26%, respectively. Enteral autonomy continued into the 5th year after study entry. Children with IF endure significant mortality and morbidity. Enteral autonomy may require years to achieve. Improved medical, nutritional, and surgical management may reduce time on PN, mortality and need for transplantation.
登录
查看更多内容
影响因子：
--
作者：
Kim, Esther Y.;Saunders, Patricia;Yousefzadeh, Nina
通讯作者：
Yousefzadeh, Nina
DOI：
10.1016/s1521-6918(03)00079-9
发表时间：
2003-12-01
影响因子：
3.2
作者：
Schalamon, J;Mayr, JM;Höllwarth, ME
通讯作者：
Höllwarth, ME
DOI：
10.1097/00005176-200406002-00012
发表时间：
2004-01-01
影响因子：
2.9
作者：
Kocoshis, SA;Beath, SV;Ohtsuka, Y
通讯作者：
Ohtsuka, Y
影响因子：
3.7
作者：
Slobbe L;Doorduijn JK;Lugtenburg PJ;El Barzouhi A;Boersma E;van Leeuwen WB;Rijnders BJ
通讯作者：
Rijnders BJ
影响因子：
8
作者：
Olsen, Irene E.;Groveman, Sue A.;Zemel, Babette S.
通讯作者：
Zemel, Babette S.