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

A. Lezo 1 A. Diamanti 2 E. M. Marinier 3 M. Tabbers 4, 5 A. Guz-Mark 6, 7 P. Gandullia 8 M. I. Spagnuolo 9 S. Protheroe 10 N. Peretti 11, 12 L. Merras-Salmio 13 J. M. Hulst 14 S. Kolaček 15 L. C. Ee 16 J. Lawrence 17 J. Hind 18 L. d'Antiga 19 G. Verlato 20 I. Pukite 21 G. Di Leo 22 T. Vanuytsel 23 M. K. Doitchinova-Simeonova 24 L. Ellegard 25 L. Masconale 26 M. Maíz-Jiménez 27 S. C. Cooper 10 G. Brillanti 28 E. Nardi 29 A. S. Sasdelli 30 S. Lal 31 L. Pironi 28, 30 
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.
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Submitted on : Monday, August 22, 2022 - 8:09:43 AM
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A. Lezo, A. Diamanti, E. M. Marinier, M. Tabbers, A. Guz-Mark, et al.. Chronic Intestinal Failure in Children: An International Multicenter Cross-Sectional Survey. Nutrients, MDPI, 2022, 14 (9), pp.1889. ⟨10.3390/nu14091889⟩. ⟨inserm-03755219⟩



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