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Neonatal intestinal failure - improved outcomes
  1. Sue Protheroe1,
  2. Ian Sugarman2
  1. 1 Department of Paediatric Gastroenterology & Nutrition, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
  2. 2 Department of Paediatric Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Dr Sue Protheroe, Gastroenterology & Nutrition, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK; sue.protheroe{at}nhs.net

https://doi.org/10.1136/flgastro-2022-102234

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    Coordination of surgical, medical and nutritional care in a multidisciplinary, integrated approach has been associated with substantially improved survival rates (>90%) for infants with intestinal failure (table 1). This condition was once virtually uniformly fatal, but intestinal rehabilitation is now effective in treating most infants and children with intestinal failure. Mortality is highest in the first year of life,1 related to underlying disease and multiple comorbidities; however, palliative care for neonates with a single organ failure is no longer the general direction of care.

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    Table 1

    Mortality rates in the paediatric intestinal failure literature

    In 2019, 389 children received home parenteral nutrition (HPN) in the UK, which is nearly double the number reported in 2012 and is a prevalence 30 per million children.2 Increasing prevalence of HPN suggests that it represents a safe and reasonable option for infants and children, with a low risk of the need for intestinal transplantation.3

    The article by Cairns et al 4 provides insights into the attitudes and decision-making of neonatologists, paediatric surgeons and gastroenterologists in the UK. There was a striking variation in decision-making for surgical neonates who were anticipated to develop intestinal failure (intestinal failure has been defined as ‘the reduction of functional gut mass below the minimal amount necessary for digestion and absorption adequate to satisfy the nutrient and fluid requirements for maintenance in adults or growth in children.5) due to short …

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    Footnotes

    • Correction notice This article has been corrected since it published Online First. The title has been updated.

    • Contributors Commissioned by the editorial team SP and IS wrote the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.

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