Pediatric Intestinal Pseudo-Obstruction

Impact of Neonatal and Later Onset on Clinical and Nutritional Outcomes

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To evaluate long-term nutritional outcomes and clinical characteristics in a cohort of children with pediatric intestinal pseudo-obstruction (PIPO) at neonatal-onset (NO-PIPO) and at later-onset (LO-PIPO).

METHODS: All children fulfilling new PIPO criteria over a thirty-year period were reviewed. Baseline demographic and clinical features as well as nutritional outcomes were collected. Nutritional outcomes included overall survival, prevalence of enteral autonomy and parenteral nutrition (PN) dependency, rate of major PN complications, and growth course.

RESULTS: Forty-four patients were still alive at the end of the follow-up. Twenty-five patients (57%) achieved enteral autonomy, whilst 18 remained on PN. Among the patients requiring PN at beginning of the study-period, we found that 55% (CI 34-70) has the probability of remaining on PN at the latest follow-up. Prevalence of gastro-intestinal obstruction symptoms (p < 0.01), urinary involvement (p < 0.05), stoma placements [gastrostomy (p < 0.01), ileostomy p < 0.05) and complex gastro-intestinal surgery (p < 0.05) were significantly higher in NO-PIPO than in LO-PIPO. The number of patients requiring long-term PN (p < 0.001)and the number of PN days (p < 0.05) were significantly higher in NO-PIPO, whilst the number of patients achieving enteral autonomy was significantly higher in LO-PIPO (p < 0.05).

CONCLUSIONS: In our study we have reported the nutritional outcome of a cohort of children with PIPO over a thirty-year period showing that about 20% of patients develop irreversible intestinal failure requiring life-long PN. Nutritional and clinical outcomes seem to be influenced by the time of onset of the disease.

Original languageEnglish
JournalJournal of Pediatric Gastroenterology and Nutrition
DOIs
Publication statusE-pub ahead of print - May 2 2019

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Intestinal Pseudo-Obstruction
Parenteral Nutrition
Pediatrics
Small Intestine
Ileostomy
Gastrostomy
Intestinal Obstruction
Enteral Nutrition
Demography

Cite this

@article{8b4e74cc810241408dd171f4637a2e54,
title = "Pediatric Intestinal Pseudo-Obstruction: Impact of Neonatal and Later Onset on Clinical and Nutritional Outcomes",
abstract = "OBJECTIVE: To evaluate long-term nutritional outcomes and clinical characteristics in a cohort of children with pediatric intestinal pseudo-obstruction (PIPO) at neonatal-onset (NO-PIPO) and at later-onset (LO-PIPO).METHODS: All children fulfilling new PIPO criteria over a thirty-year period were reviewed. Baseline demographic and clinical features as well as nutritional outcomes were collected. Nutritional outcomes included overall survival, prevalence of enteral autonomy and parenteral nutrition (PN) dependency, rate of major PN complications, and growth course.RESULTS: Forty-four patients were still alive at the end of the follow-up. Twenty-five patients (57{\%}) achieved enteral autonomy, whilst 18 remained on PN. Among the patients requiring PN at beginning of the study-period, we found that 55{\%} (CI 34-70) has the probability of remaining on PN at the latest follow-up. Prevalence of gastro-intestinal obstruction symptoms (p < 0.01), urinary involvement (p < 0.05), stoma placements [gastrostomy (p < 0.01), ileostomy p < 0.05) and complex gastro-intestinal surgery (p < 0.05) were significantly higher in NO-PIPO than in LO-PIPO. The number of patients requiring long-term PN (p < 0.001)and the number of PN days (p < 0.05) were significantly higher in NO-PIPO, whilst the number of patients achieving enteral autonomy was significantly higher in LO-PIPO (p < 0.05).CONCLUSIONS: In our study we have reported the nutritional outcome of a cohort of children with PIPO over a thirty-year period showing that about 20{\%} of patients develop irreversible intestinal failure requiring life-long PN. Nutritional and clinical outcomes seem to be influenced by the time of onset of the disease.",
author = "Antonella Diamanti and Fabio Fusaro and Tamara Caldaro and Teresa Capriati and Manila Candusso and Valerio Nobili and Osvaldo Borrelli",
year = "2019",
month = "5",
day = "2",
doi = "10.1097/MPG.0000000000002373",
language = "English",
journal = "Journal of Pediatric Gastroenterology and Nutrition",
issn = "0277-2116",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Pediatric Intestinal Pseudo-Obstruction

T2 - Impact of Neonatal and Later Onset on Clinical and Nutritional Outcomes

AU - Diamanti, Antonella

AU - Fusaro, Fabio

AU - Caldaro, Tamara

AU - Capriati, Teresa

AU - Candusso, Manila

AU - Nobili, Valerio

AU - Borrelli, Osvaldo

PY - 2019/5/2

Y1 - 2019/5/2

N2 - OBJECTIVE: To evaluate long-term nutritional outcomes and clinical characteristics in a cohort of children with pediatric intestinal pseudo-obstruction (PIPO) at neonatal-onset (NO-PIPO) and at later-onset (LO-PIPO).METHODS: All children fulfilling new PIPO criteria over a thirty-year period were reviewed. Baseline demographic and clinical features as well as nutritional outcomes were collected. Nutritional outcomes included overall survival, prevalence of enteral autonomy and parenteral nutrition (PN) dependency, rate of major PN complications, and growth course.RESULTS: Forty-four patients were still alive at the end of the follow-up. Twenty-five patients (57%) achieved enteral autonomy, whilst 18 remained on PN. Among the patients requiring PN at beginning of the study-period, we found that 55% (CI 34-70) has the probability of remaining on PN at the latest follow-up. Prevalence of gastro-intestinal obstruction symptoms (p < 0.01), urinary involvement (p < 0.05), stoma placements [gastrostomy (p < 0.01), ileostomy p < 0.05) and complex gastro-intestinal surgery (p < 0.05) were significantly higher in NO-PIPO than in LO-PIPO. The number of patients requiring long-term PN (p < 0.001)and the number of PN days (p < 0.05) were significantly higher in NO-PIPO, whilst the number of patients achieving enteral autonomy was significantly higher in LO-PIPO (p < 0.05).CONCLUSIONS: In our study we have reported the nutritional outcome of a cohort of children with PIPO over a thirty-year period showing that about 20% of patients develop irreversible intestinal failure requiring life-long PN. Nutritional and clinical outcomes seem to be influenced by the time of onset of the disease.

AB - OBJECTIVE: To evaluate long-term nutritional outcomes and clinical characteristics in a cohort of children with pediatric intestinal pseudo-obstruction (PIPO) at neonatal-onset (NO-PIPO) and at later-onset (LO-PIPO).METHODS: All children fulfilling new PIPO criteria over a thirty-year period were reviewed. Baseline demographic and clinical features as well as nutritional outcomes were collected. Nutritional outcomes included overall survival, prevalence of enteral autonomy and parenteral nutrition (PN) dependency, rate of major PN complications, and growth course.RESULTS: Forty-four patients were still alive at the end of the follow-up. Twenty-five patients (57%) achieved enteral autonomy, whilst 18 remained on PN. Among the patients requiring PN at beginning of the study-period, we found that 55% (CI 34-70) has the probability of remaining on PN at the latest follow-up. Prevalence of gastro-intestinal obstruction symptoms (p < 0.01), urinary involvement (p < 0.05), stoma placements [gastrostomy (p < 0.01), ileostomy p < 0.05) and complex gastro-intestinal surgery (p < 0.05) were significantly higher in NO-PIPO than in LO-PIPO. The number of patients requiring long-term PN (p < 0.001)and the number of PN days (p < 0.05) were significantly higher in NO-PIPO, whilst the number of patients achieving enteral autonomy was significantly higher in LO-PIPO (p < 0.05).CONCLUSIONS: In our study we have reported the nutritional outcome of a cohort of children with PIPO over a thirty-year period showing that about 20% of patients develop irreversible intestinal failure requiring life-long PN. Nutritional and clinical outcomes seem to be influenced by the time of onset of the disease.

U2 - 10.1097/MPG.0000000000002373

DO - 10.1097/MPG.0000000000002373

M3 - Article

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

SN - 0277-2116

ER -