Chronic Intestinal Failure in Children: An International Multicenter Cross-Sectional Survey

Antonella Lezo, Antonella Diamanti, Evelyne M. Marinier, Merit Tabbers, Anat Guz-Mark, Paolo Gandullia, Maria I. Spagnuolo, Sue Protheroe, Noel Peretti, Laura Merras-Salmio, Jessie M. Hulst, Sanja Kolaček, Looi C. Ee, Joanna Lawrence, Jonathan Hind, Lorenzo D’antiga, Giovanna Verlato, Ieva Pukite, Grazia Di Leo, Tim VanuytselMaryana K. Doitchinova-Simeonova, Lars Ellegard, Luisa Masconale, María Maíz-Jiménez, Sheldon C. Cooper, Giorgia Brillanti, Elena Nardi, Anna S. Sasdelli, Simon Lal, Loris Pironi*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: The European Society for Clinical Nutrition and Metabolism database for chronic intestinal failure (CIF) was analyzed to investigate factors associated with nutritional status and the intravenous supplementation (IVS) dependency in children. Methods: Data collected: demographics, CIF mechanism, home parenteral nutrition program, z-scores of weight-for-age (WFA), length or height-for-age (LFA/HFA), and body mass index-for-age (BMI-FA). IVS dependency was calculated as the ratio of daily total IVS energy over estimated resting energy expenditure (%IVSE/REE). Results: Five hundred and fifty-eight patients were included, 57.2% of whom were male. CIF mechanisms at age 1–4 and 14–18 years, respectively: SBS 63.3%, 37.9%; dysmotility or mucosal disease: 36.7%, 62.1%. One-third had WFA and/or LFA/HFA z-scores < −2. One-third had %IVSE/REE > 125%. Multivariate analysis showed that mechanism of CIF was associated with WFA and/or LFA/HFA z-scores (negatively with mucosal disease) and %IVSE/REE (higher for dysmotility and lower in SBS with colon in continuity), while z-scores were negatively associated with %IVSE/REE. Conclusions: The main mechanism of CIF at young age was short bowel syndrome (SBS), whereas most patients facing adulthood had intestinal dysmotility or mucosal disease. One-third were underweight or stunted and had high IVS dependency. Considering that IVS dependency was associated with both CIF mechanisms and nutritional status, IVS dependency is suggested as a potential marker for CIF severity in children.

Original languageEnglish
Article number1889
JournalNutrients
Volume14
Issue number9
DOIs
Publication statusPublished - 1 May 2022

Bibliographical note

Funding Information:
Funding: The project of the ESPEN database for Chronic Intestinal Failure was promoted by the ESPEN Executive Committee in 2013, was approved by the ESPEN Council and was supported by an ESPEN grant.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

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