Elements of successful intestinal rehabilitation

Sigalet, David L.; Boctor, Dana; Brindle, Mary; Lam, Viona; Robertson, M A

doi:10.1016/j.jpedsurg.2010.09.083

Cited by 65 publications

(61 citation statements)

References 30 publications

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“…In 1997-2003, we also reported that a CB !100 micromol/L was predictive of deteriorating end-stage liver disease in a neonatal short bowel cohort of patients (14). In contrast, Sigalet et al found that none of their patients in the recent (4). Not only is the incidence of IFALD lower in the current era, but also we now recognize that it is sometimes possible to reverse this process.…”

Section: Discussionmentioning

confidence: 85%

“…The criteria reflect and were based on the outcomes of IF 20-30 years ago, at a time when this condition was associated with high mortality rates. Subsequently, there have been many advances in the medical and surgical management of children with IF resulting in much better outcomes (3)(4)(5)(6). These improvements include: the adoption of multi-disciplinary intestinal rehabilitation teams, autologous bowel reconstruction techniques, and the introduction of new medical approaches such as ethanol locks to reduce cathether related sepsis (7) and novel lipid management strategies (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

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Pediatric Intestinal Transplant Listing Criteria – A Call for a Change in the New Era of Intestinal Failure Outcomes

Burghardt

Wales

Silva³

et al. 2015

American Journal of Transplantation

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Current listing indications used for intestinal transplantation (IT) were proposed in 2001. We undertook the present single center study to see if these criteria are still valid. The 2001 criteria (advanced cholestasis, loss of >50% central venous catheter (CVC) sites, !2 sepsis/year, ultrashort bowel) were compared in children with intestinal failure in old era-1998-2005 (N ¼ 99) to current era-2006-2012 (N ¼ 91) to predict the need for IT using sensitivity, specificity, NPV and PPV. Two 2001 criteria had poorer predictive value in the current era: Advanced cholestasis (PPV 64% old vs. 40% current era; sensitivity 84% vs. 65%, respectively) and ultrashort bowel (PPV 100% old vs. 9% current era; sensitivity 10% vs. 4%, respectively). Three newly proposed criteria had high predictive value: !2 ICU admissions (p ¼ 0.0001, OR 23.6, 95% CI 2.7-209.8), persistent bilirubin >75 mmol/L despite lipid strategies (p ¼ 0.0005, OR 24.0, 95% CI 3.2-177.4), and loss of !3 CVC sites (p ¼ 0.0003, OR 33.3,).There was 98% probability of needing IT when two of these new criteria were present. The 2001 IT criteria have limited predictive ability in the current era and should be revised. A multicenter study is required to validate the findings of this single center experience.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Pediatric Intestinal Transplant Listing Criteria – A Call for a Change in the New Era of Intestinal Failure Outcomes

Burghardt

Wales

Silva³

et al. 2015

American Journal of Transplantation

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“…Sıklığın giderek gerek gastrokizis gerek prematür bebeklerin yaşam oranının artması ve dolayısıyla NEK sıklığı-nın artmasıyla orantılı arttığı da bildirilmektedir (2) .…”

Section: Kbs Insidansunclassified

“…Yaşamın ilk yılında 100 cm'den daha kısa bağırsak miktarı anormal kabul edilir. Kısa bağırsak sendromu denebilmesi için geleneksel olarak 40 cm ve daha az miktar bağırsak varlığı yanısıra kimi merkeze göre 42 gün (2) , kimine göre 3 ay, kimine göre ise 6 aydan daha uzun süren total parenteral beslenme gereksinimi olmalıdır. Ayrıca gestasyonel yaş, hastanın KBS olduğu aktuel zamanlamanın ve altta yatan patolojinin de göz önüne alınması gerektiği vurgulanmaktadır (3,4) .…”

Section: Introductionunclassified

Intestinal Failure/Nontransplant surgical interventions for short bowel syndrome

Çelik¹

2017

tcdd

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Öz GirişBağırsak sisteminin bireyin besin alımı ve sıvı dengesini sağlamada yetersiz kaldığı durumlara bağırsak yetmezliği adı verilmektedir. Bağırsak uzunluğunun azaldığı, ileoçekal valvin olmadığı, kolonun kaybedildiği gibi uzunluk kayıpları veya mukozal yetmezlik, dismotilite veya aktif enterit gibi besin emiliminin mümkün olmadığı durumlarda birey kalıcı veya uzun süreli total parenteral beslenmeye mecbur kalabilmektedir (1) . "Büyüme için gerekli sıvı ve besinlerin sindirimi ve emilimi için yeterli miktarda fonksiyonel bağırsak kalmaması" pediatrik bağırsak yetmezliğinin modern tanımlamasıdır. Bir başka tanımda ise, büyüme, hidrasyon ve elektrolit homeostazının bozulmasına neden olan bağırsak hastalığı olarak genellenebilmektedir.

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“…Further, in adults, 5-year patient survival for the subgroup of patients with home PN failure (complications that are considered indications for intestine transplantation) was 73% and the majority of deaths were related to home PN in patients PN dependent for greater than 2 years (7). Several single center studies have demonstrated decreased mortality for PN-dependent patients through the establishment of a multi-disciplinary team for the management of intestinal failure, introduction of ethanol lock or antibiotic locks for prevention of infection, and surgical autologous gastrointestinal (GI) reconstruction in selected patients (8)(9)(10)(11)(12). Specialized intestinal failure centers achieve better outcomes by applying maximal and appropriate medical and surgical therapies and providing timely referral for transplantation when these more conservative measures fail (10).…”

Section: Purpose Of Reviewmentioning

confidence: 99%

The Current State of Intestine Transplantation: Indications, Techniques, Outcomes and Challenges

Sudan

2014

American Journal of Transplantation

112

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Intestine transplantation is the least common form of organ transplantation in the United States and often deemed one of the most difficult. Patient and graft survival have historically trailed well behind other organ transplants. Over the past 5-10 years registry reports and single center series have demonstrated improvements to patient survival after intestinal transplantation that now match patient survival for those without life-threatening complications on parenteral nutrition. For various reasons including improvements in medical care of patients with intestinal failure and difficulty accessing transplant care, the actual number of intestine transplants has declined by 25% over the past 6 years. In light of the small numbers of intestine transplants, many physicians and the lay public are often unaware that this is a therapeutic option. The aim of this review is to describe the current indications, outcomes and advances in the field of intestine transplantation and to explore concerns over future access to this important and life-saving therapy.

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Elements of successful intestinal rehabilitation

Cited by 65 publications

References 30 publications

Pediatric Intestinal Transplant Listing Criteria – A Call for a Change in the New Era of Intestinal Failure Outcomes

Pediatric Intestinal Transplant Listing Criteria – A Call for a Change in the New Era of Intestinal Failure Outcomes

Intestinal Failure/Nontransplant surgical interventions for short bowel syndrome

The Current State of Intestine Transplantation: Indications, Techniques, Outcomes and Challenges

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