Open AccessOutcomes of the First 54 Pediatric Patients on Long‐Term Home Parenteral Nutrition from a Single Brazilian Center
Author(s) -
Goldani Helena A.S.,
Ceza Marilia R.,
Godoy Liege L.,
Giesta Juliana M.,
Beier Simone,
Oliveira Juliana G.,
Nunes Daltro L.,
Feldens Leticia,
Lucena Iara R.S.,
Taniguchi Adriano N.R.,
Hallberg Silvia C.,
Durant Daiane,
Boettcher Simone,
Schneider Marcia A.,
Mello Patricia P.,
Riberg Mariana G.L.,
Signorini Alana V.,
Miller Cristina,
Santos Berenice L.,
Silveira Claudete O.,
Morais Maira C.M.,
Laggazio Terezinha V.,
Costa Carla C.,
Kieling Carlos O.
Publication year - 2022
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000003473
Subject(s) - medicine , parenteral nutrition , enteral administration , short bowel syndrome , intestinal failure , pediatrics , surgery
Objectives: Data on multidisciplinary programs dedicated to home parenteral nutrition (HPN) in Latin America are limited. This study describes the results of the first multidisciplinary pediatric intestinal rehabilitation program for HPN at a public tertiary hospital in Brazil. Methods: We retrospectively reviewed patients aged 0–18 years with intestinal failure (IF) who required parenteral nutrition (PN) for >60 days between January/2014 and December/2020. Results: Fifty‐four patients were discharged on HPN (15 achieved enteral autonomy, 34 continued on HPN at the end of the study, 1 underwent intestinal transplantation, and 4 died). The median (IQR) age at the study endpoint of patients who achieved enteral autonomy was 14.1 (9.7–19) versus 34.7 (20.4–53.9) months in those who did not achieve enteral autonomy. Overall prevalence of catheter‐related thrombosis was 66.7% and catheter‐related bloodstream infection rate was 0.39/1000 catheter‐days. Intestinal failure‐associated liver disease (IFALD) was present in 24% of all patients; none of the patients who achieved enteral autonomy had IFALD. All patients showed significant improvement in anthropometric parameters during the HPN period. The sociodemographic characteristics of the patients’ family members were mothers less than 20 years old (7.5%), schooling time more than 10 years (55.5%), and household income between 1 and 3 times the minimum wage (64.8%). The 5‐year survival rate for HPN is 90%, and 27.7% of patients achieve enteral autonomy. Conclusion: The treatment of pediatric patients with IF followed by a multidisciplinary pediatric intestinal rehabilitation program with HPN is feasible and safe in the Brazilian public health system.