Improved Outcomes in Paediatric Intestinal Failure with Aggressive Prevention of Liver Disease

Sigalet, David L.; Boctor, Dana; Robertson, M A; Lam, Viona; Brindle, Mary; Sarkhosh, Kourosh; Driedger, L. J.; Sajedi, Mitra

doi:10.1055/s-0029-1241865

Cited by 94 publications

(76 citation statements)

References 31 publications

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“…Thus, it may be other factors, specific signals, a combination of factors, or variations in the sensitivity to trophic ligands induced by changes in receptor expression, which control apoptosis and the morphological adaptation that is stimulated by nutrient contact [46,48]. Whatever the underlying signals, it is clear that adaptation is maximally stimulated in mucosa that is exposed to nutrients; this is important in the clinical management of patients [6,11].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The influence of nutrients, biliary-pancreatic secretions, and systemic trophic hormones on intestinal adaptation in a Roux-en-Y bypass model

Taqi

Wallace

Heuvel

et al. 2010

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

“…Short bowel syndrome is a serious condition that can carry a mortality rate of 15% to 25% [4][5][6][7], unless the residual intestine undergoes adaptation. In adaptation, the small intestine increases both its surface area and the absorptive enzymatic capacity, primarily by increasing the rate of crypt cell proliferation [8,9].…”

mentioning

confidence: 99%

The influence of nutrients, biliary-pancreatic secretions, and systemic trophic hormones on intestinal adaptation in a Roux-en-Y bypass model

Taqi

Wallace

Heuvel

et al. 2010

Journal of Pediatric Surgery

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“…Neonatal cholestasis is associated with increased mortality and morbidities such as cirrhosis and liver failure [4,5]. Early diagnosis and aggressive treatment of infants at risk for liver failure improve outcomes [6,7]. …”

Section: Introductionmentioning

confidence: 99%

Early Inflammatory Markers for Prediction of Cholestasis in Very-Low-Birth-Weight Infants

et al. 2012

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Background: Neonatal cholestasis is associated with increased mortality and other adverse outcomes. There are no tools for prediction of infants at risk for cholestasis. Objective: To determine if cholestasis in very-low-birth-weight (VLBW) infants is associated with alterations in cytokines or C-reactive protein (CRP) and, if so, whether inflammatory markers predict which infants will develop cholestasis. Methods: VLBW infants expected to be on parenteral nutrition for >7 days were enrolled in this prospective cohort study. Infants with direct bilirubin ≥1.0 mg/dl were considered to have a high risk for cholestasis and were compared to infants who never developed direct bilirubin ≥1.0 mg/dl. Standard descriptive statistics were used to compare biomarkers over time. Multivariable models were used to estimate associations between early inflammatory markers and cholestasis. Results: Of 63 infants enrolled, 29 were at risk for cholestasis. CRP was highly correlated with direct bilirubin. Infants in the high-risk group had significantly higher IL-1β, IL-6, IL-8, and IL-10 at 2, 4, and 6 weeks and CRP at 2 and 6 weeks. In logistic models, CRP (OR = 4.97, p = 0.02) or IL-1β (OR = 1.11, p = 0.008) at 2 weeks of age was predictive of cholestasis. In linear mixed-effects models, CRP (p < 0.001) or IL-6 (p = 0.02) and IL-8 (p < 0.001) were predictive of cholestasis. Conclusion: Elevated CRP and cytokines are associated with cholestasis in VLBW infants. These inflammatory markers are candidates for further research into the pathogenesis, prediction, and prevention of cholestasis.

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“…IF patients treatment conducted by specialized centres with sufficient experience has been rightfully declared an important condition of successful HPN program [2,3,4,5,7,12,19,21]. In the Czech Republic (population 10 million), the 66 reported patients were followed by 8 departments in the course of 16 years, with only 3 centres treating more than 10 children (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Advances in technology, catheter care, parenteral nutrition composition, prevention of hepatopathy, infection, and thrombosis as well as systematic intestinal rehabilitation, pharmacologic support of adaptation, and non-transplant surgical techniques account for decreasing mortality/morbidity and increasing rates of intestinal adaptation [8,9,10,11,12,13,14,15,16,17,18]. In recent surveys, the prognosis of patients on long-term HPN, especially those with short bowel syndrome (SBS), was found to be better than in those treated by intestinal transplantation [19,20].…”

Section: Introductionmentioning

confidence: 99%

Paediatric Home Parenteral Nutrition in the Czech Republic and Its Development: Multicentre Retrospective Study 1995-2011

Stýblová¹,

Kalousová

Adamcová³

et al. 2017

Ann Nutr Metab

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Background: Treatment quality and outcomes of paediatric home parenteral nutrition (HPN) program during its development in the Czech Republic. Methods: A retrospective study of patients receiving HPN from May 1995 till June 2011. Results: Sixty-six patients were treated in 8 centres. In 48 patients, long-term PN began in the first year of life and in 35 of them in the first month. Sixty children had gastrointestinal and 6 had non-gastrointestinal disease. In a majority of the patients, the Broviac catheter was used. Thirty-two (48.5%) patients were weaned from PN after 1-117 months, 21 (32.8%) continued on HPN after 7-183 months, and 13 (19.7%) patients died, all on PN. The mortality in patients with primary gastrointestinal disease was significantly lower than in patients with non-gastrointestinal disease. Thirty-one paediatric patients were receiving HPN for 14,480 catheter days in 2009-2010. Fourteen patients had 23 Catheter Related Blood Stream Infections (CRBSI) episodes. The incidence of CRBSI in 2009-2010 was 1.58/1,000 catheter days. Conclusion: Submitted data showed that even in the absence of expert centres, patient care may achieve results comparable to countries with well-developed HPN program. A majority of Czech HPN patients are at present treated in specialized centres, following the most desirable pattern of care.

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Improved Outcomes in Paediatric Intestinal Failure with Aggressive Prevention of Liver Disease

Cited by 94 publications

References 31 publications

The influence of nutrients, biliary-pancreatic secretions, and systemic trophic hormones on intestinal adaptation in a Roux-en-Y bypass model

The influence of nutrients, biliary-pancreatic secretions, and systemic trophic hormones on intestinal adaptation in a Roux-en-Y bypass model

Early Inflammatory Markers for Prediction of Cholestasis in Very-Low-Birth-Weight Infants

Paediatric Home Parenteral Nutrition in the Czech Republic and Its Development: Multicentre Retrospective Study 1995-2011

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