Predicting time to full enteral nutrition in children after significant bowel resection
Topic overview
Retrospective study of 71 children post-bowel resection identifies remaining small bowel length as the strongest predictor of parenteral nutrition duration. Children retaining 25-50% of expected bowel required ~2 years to wean versus ~1 year for those with 51-75%, enabling clinicians to set realistic expectations for families.
Key takeaways
- Small bowel length and percent of expected bowel for gestational age strongly predict PN duration after resection (p<0.01).
- Children with 25-50% remaining small bowel require ~2 years of PN vs ~1 year for those with 51-75% remaining bowel.
- Presence of ileocecal valve, colon, or anastomosis location do not independently predict time to enteral autonomy.
- Linear regression model using remaining bowel length can estimate PN dependence duration after major pediatric resection.
- Most cases involved NEC (56%), intestinal atresia (20%), or gastroschisis (11%) with median residual bowel 55 cm.
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