Intestinal failure in infants with necrotizing enterocolitis

Abstract

Intestinal failure is defined as a decrease in bowel function below the minimum necessary tto maintain growth, hydration and/or electrolyte balance when an intravenous supplement is required to maintain health and/or growth. As survival for infants with premature birth is increasing with better medical and surgical management, the potential exists for more children to survive with compromised gastrointestinal function and intestinal failure, especially because of necrotizing enterocolitis.The consequences of intestinal failure in infants are severe and include an increased mortality rate, recurrent central venous catheter infections, parenteral nutrition–associated liver disease, chronic diarrhea, multiple micronutrient deficiencies, and poor growth.Treatment of intestinal failure is aimed at achievement of adequate enteral nutrition. Limited data also support an association between Intestinal failure in infants and postoperative nutritional management, including early enteral feeding. Patients with intestinal failure need long-term parenteral nutrition support until intestinal adaptation occurs. Children with severe intestinal failure and prolonged dependence on parenteral nutrition are susceptible to the development of various complications and need long-term regular monitoring to prevent these complications.The purpose of this review is to of the available evidence to answer a series of questions regarding effective clinical management of children with intestinal failure receiving parenteral or enteral nutrition.