A Review on Safety and Outcomes of Mucous Fistula Refeeding in Neonates
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Jun 2022 · 1 min read
In brief
In brief
This systematic review of 11 studies (197 neonates) examines mucous fistula refeeding as a strategy to promote intestinal adaptation in short bowel syndrome. Evidence suggests MFR is generally safe and may accelerate weight gain, reduce parenteral nutrition dependence, and improve post-reversal outcomes, though standardized protocols are lacking.
Written by the GCMD Library team from the article.
Introduction: The utility of mucous fistula refeeding (MFR) in neonates with short bowel syndrome is widely debated. Our purpose is to review MFR and outline methods, reported complications, and clinical outcomes (survival, weight gain, dependence on parenteral nutrition [PN], and time to enteral autonomy).
Materials and methods: We performed a MEDLINE literature search and reference review from January 1980 to May 2020 for terms ("mucous fistula re-feeding" or "enteral re-feeding") and neonates. We included studies that utilized conventional MFR in the neonatal period. Non-English language articles were excluded.
Results: We identified 11 relevant articles. Internationally, there was no consensus on methods of MFR. A total of 197 neonates underwent MFR. Within a single study, four neonates developed major complications; however, the procedure was well tolerated without major complications in 10 of the 11 studies. A mortality of nine patients during MFR highlights the burden of disease within the study population; however, of these, only one was directly attributable to MFR. Minor complications were seldom quantified. Three studies demonstrated a higher rate of weight gain and shorter PN support versus controls. Neonates who underwent MFR had lower chance of anastomotic leak and quicker progression to full feed after reversal versus controls. The influence of microorganisms in MFR was only investigated in one study.
Conclusion: Current evidence suggests benefits of MFR; however, an international consensus is yet to be reached on the optimal method. A large prospective study investigating the influence of MFR on the enteric system is required.
DOI: 10.1055/s-0040-1718751