Outcomes of the first 54 pediatric patients on long-term home parenteral nutrition from a single Brazilian center

• Autor(a) principal: Goldani, Helena Ayako Sueno
• Data de Publicação: 2022
• Outros Autores: Ceza, Marília Rosso, Godoy, Liége Lessa, Giesta, Juliana Mariante, Beier, Simone, Oliveira, Juliana Ghisleni de, Nunes, Daltro Luiz Alves, Feldens, Letícia, Lucena, Iara Regina Siqueira, Taniguchi, Adriano Nori Rodrigues, Hallberg, Silvia Cristina Marceliano, Durant, Daiane Marques, Boettcher, Simone, Schneider, Márcia Andréa de Oliveira, Mello, Patrícia Piccoli de, Riberg, Mariana Galvão Lopes, Signorini, Alana Verza, Miller, Cristina, Santos, Berenice Lempek dos, Silveira, Claudete Oliveira, Morais, Maíra Cristina Machado, Laggazio, Terezinha Vieira da Conceição, Costa, Carla Cristine, Kieling, Carlos Oscar
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRGS
• Texto Completo: http://hdl.handle.net/10183/250375
• topic: Reabilitação; Insuficiência intestinal; Nutrição parenteral; Síndrome do intestino curto; Criança; Intestinal rehabilitation; Intestinal failure; Short bowel syndrome; Home parenteral nutrition; Children

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 catheterrelated 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.