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  • Fredriksson, Fanny,1985-Uppsala universitet,Barnkirurgisk forskning,Section of Pediatric Surgery, Uppsala University Children's Hospital, Uppsala, Sweden (author)

Improved Outcome of Intestinal Failure in Preterm Infants

  • Article/chapterEnglish2020

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  • Wolters Kluwer,2020
  • electronicrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:uu-416234
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-416234URI
  • https://doi.org/10.1097/MPG.0000000000002763DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

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  • De två första författarna delar förstaförfattarskapet
  • OBJECTIVE: The aims were to evaluate the outcome and to identify predictors for survival and enteral autonomy in neonatal intestinal failure (IF).METHODS: A retrospective observational study in a Swedish tertiary centre of children born between 1995 and 2016 with neonatal IF, defined as dependency on parenteral nutrition (PN) ≥60 days, starting with PN before the age of 44 gestational weeks. Data were extracted from medical records and predictors for survival and enteral autonomy were identified by the Cox regression model. Time to death and weaning off PN analysis were performed with Kaplan-Meier curves including log rank test.RESULTS: In total, 105 children were included. Median gestational age was 28 weeks (22-42), 50% were born extremely preterm (<28 gestational weeks). PN started at a median age of two days (0-147) with a median duration of 196 days (60-3091). Necrotising enterocolitis was the dominating cause of IF (61%). Overall survival was 88%, five children died of sepsis and four of intestinal failure-associated liver disease. Survival increased from 75% during 1995-2008 to 96% during 2009-2016 (p = 0.0040). Age-adjusted small bowel length of >50% and birth 2009-2016 were predictors for survival. Enteral autonomy was achieved in 87%, with positive prediction by small bowel length of >25% of expected for gestational age and remaining ileocaecal valve.CONCLUSION: Preterm neonates with IF, at high risk of IF associated morbidity, showed a high overall survival rate. Small-bowel length and being born 2009-2016 were predictors for survival and remaining ICV and small-bowel length were predictors for enteral autonomy.

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  • Nyström, NiklasUppsala universitet,Pediatrisk inflammations- och metabolismforskning samt barnhälsa,Section of Pediatric Gastroenterology, Uppsala University Children's Hospital, Uppsala, Sweden(Swepub:uu)nikny423 (author)
  • Waldenvik, KajsaSection of Pediatric Gastroenterology, Uppsala University Children's Hospital, Uppsala, Sweden (author)
  • Ördén, HeleneSection of Pediatric Gastroenterology, Uppsala University Children's Hospital, Uppsala, Sweden (author)
  • Lindblom, MajaSection of Pediatric Surgery, Uppsala University Children's Hospital, Uppsala, Sweden (author)
  • Paulsson, MattiasUppsala universitet,Barnneurologi/Barnonkologi,Hospital Pharmacy, Uppsala University Children's Hospital, Uppsala, Sweden(Swepub:uu)mpa14028 (author)
  • Finkel, YigaelSection of Pediatric Gastroenterology, Uppsala University Children's Hospital, Uppsala, Sweden (author)
  • Engstrand Lilja, Helene,1963-Uppsala universitet,Barnkirurgisk forskning,Section of Pediatric Surgery, Uppsala University Children's Hospital, Uppsala, Sweden(Swepub:uu)helelilj (author)
  • Uppsala universitetBarnkirurgisk forskning (creator_code:org_t)

Related titles

  • In:Journal of Pediatric Gastroenterology and Nutrition - JPGN: Wolters Kluwer71:2, s. 223-2310277-21161536-4801

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