Blenderized enteral nutrition in pediatric short gut syndrome: Tolerance and clinical outcomes.
Blenderized enteral nutrition in pediatric short gut syndrome: Tolerance and clinical outcomes.
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DOI：
10.1002/ncp.10866
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发表时间：
2022-08
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影响因子：
--
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中科院分区：
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--
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由全食物成分组成的混合饲料正在成为肠内营养的首选方法。然而，在短肠综合征（SBS）中，这种策略的循证指导有限。我们的目的是探讨SBS患者对混合饲料的耐受性和临床结局。我们进行了一项关于混合饲料治疗儿童SBS的单中心回顾性研究。在筛选的376例患者中，58例符合入选标准。三名患者由于在开始混合饲料之前有肠移植史而被排除。收集并分析人口统计学、临床病史和营养史。患者在混合饲料中腹泻改善，但气体恶化。与继续使用混合物的患者相比，停止使用混合物的患者的平均小肠长度无显著差异。然而，结肠切除的患者更有可能停止混合。在体重减轻但腹泻改善的患者亚组（N=19）中，大多数患者有回盲瓣（ICV）和结肠切除术史，但与体重未减轻的患者相比，平均小肠长度无差异。我们的SBS患者队列在混合饲料后胃肠道症状和粪便质量得到改善。没有ICV和结肠切除术的患者更容易体重减轻。在一部分患者中，可能需要逐步滴定混合配方奶粉与既往配方奶粉方案，以优化耐受性和体重增加。进一步的研究是必要的，以了解因素，有助于可变的耐受性和体重增加的混合配方，以指导他们的使用与SBS患者。
Blenderized feeds consisting of whole food components are emerging as a preferred approach to enteral nutrition. However, there is limited evidence-based guidance for this strategy in short bowel syndrome (SBS). We aim to explore the tolerance and clinical outcome of blenderized feeds in patients with SBS. We conducted a single-center, retrospective study of blenderized feeds in pediatric SBS. Of the 376 patients screened, 58 met inclusion criteria. Three patients were excluded due to a history of bowel transplant prior to blenderized feed initiation. Demographics, clinical history, and nutritional history were collected and analyzed. Patients had improved diarrhea though worsening gas while on blenderized feeds. There was no significant difference in average small bowel length in patients who discontinued blends compared to those who continued. However, patients with colonic resection were more likely to discontinue the blends. In a subgroup of patients who lost weight despite improved diarrhea (N=19), most had a history of ileocecal valve (ICV) and colonic resection, but no difference in average small bowel length compared to those who did not lose weight. Our cohort of patients with SBS experienced improved gastrointestinal symptoms and stool quality on blenderized feeds. Patients without an ICV and with colonic resection were more prone to weight loss. Stepwise titration of blenderized formula with previous formula regimen may be needed in a subset of patients to optimize tolerance and weight gain. Further study is warranted to understand factors contributing to variable tolerance and weight gain on blenderized formulas to guide their use in patients with SBS.
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