Organization and outcomes of multidisciplinary intestinal failure teams
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In brief
In brief
This article examines how multidisciplinary intestinal failure teams have transformed pediatric outcomes over two decades, achieving survival rates exceeding 90%. It reviews team composition, care strategies including parenteral nutrition and bowel lengthening, and long-term patient outcomes from leading programs.
Written by the GCMD Library team from the article.
Publication date: August 2018
Source: Seminars in Pediatric Surgery, Volume 27, Issue 4
Author(s): Patrick J. Javid, Danielle Wendel, Simon P. Horslen
Abstract
Multidisciplinary intestinal failure programs have played a leading role in the improved outcomes observed in children with intestinal failure over the past two decades. These teams evolved from the world of transplantation and now provide comprehensive care of intestinal failure patients and their families. In addition, they provide the foundation for outcomes research and clinical trials in pediatric intestinal failure. The history and composition of multidisciplinary intestinal failure programs is outlined here with a particular emphasis on long-term patient outcomes as reported from the programs themselves.
The care of children with intestinal failure has rapidly evolved over the past two decades. In the contemporary era, children with intestinal failure now have a favorable long-term prognosis, and survival is routinely greater than 90%. The improvement in outcomes in this population is secondary to a variety of advances including safe strategies to deliver chronic parenteral nutrition (PN), innovative bowel lengthening techniques, preservation of vascular access, and prevention of sepsis. However, the underlying driver of these advances in care is widely considered to be the advent of multidisciplinary intestinal failure and rehabilitation programs to manage these patients in a comprehensive fashion.