Mucous Fistula Refeeding Promotes Earlier Enteral Autonomy in Infants with Small Bowel Resection
pubmed.ncbi.nlm.nih.gov shows its articles on its own site.
Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Oct 2021 · 1 min read
In brief
In brief
Retrospective study of 101 infants with NEC or small bowel atresia demonstrates that mucous fistula refeeding significantly accelerates enteral autonomy, reducing parenteral nutrition duration by 22 days and improving liver function markers without increased complications. The intervention shows particular benefit in NEC patients, supporting its use as a safe strategy to enhance bowel adaptation before reanastomosis.
Written by the GCMD Library team from the article.
Objective: Infants requiring intestinal resection due to necrotizing enterocolitis (NEC) or small bowel atresia (SBA) may benefit from mucous fistula refeeding (MFR) of enterostomy output to improve nutrition and bowel adaptation before reanastomosis. Previous series demonstrated improved outcomes with MFR but did not account for varied patient characteristics as potential sources of bias. We performed a cohort analysis using multivariable adjusted models to compare outcomes of patients with and without MFR.
Methods: Retrospective chart review was performed for patients with NEC or SBA and small bowel resection with enterostomy and mucous fistula. Demographic and outcome data was compared between MFR and non-MFR groups using adjusted multivariable analysis for potential confounding variables.
Results: MFR was performed in 65 of 101 patients (64%), including 45 of 75 patients with NEC and 20 of 26 patients with SBA. Reasons for not receiving MFR included bowel stricture, technical limitation, or not otherwise specified. NEC patients receiving MFR had 14 fewer days to achieve full enteral feeds after intestinal reconnection, 22 fewer days of parenteral nutrition, lower peak direct bilirubin by 2.4 mg/dL, and 77% less odds of ursodiol use (all P < 0.01). SBA patients had similar trends not reaching statistical significance. Growth parameters were improved in MFR groups. There were no complications or increased infections from MFR.
Conclusion: This study suggests that MFR safely improves nutritional outcomes in infants with intestinal resection, related to decreased TPN dependence and earlier enteral autonomy.
DOI: 10.1097/MPG.0000000000003272