¿Hay novedades en el tratamiento del síndrome de intestino corto en el paciente pediátrico? Situación actual.

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Bibliographic Details
Title:	¿Hay novedades en el tratamiento del síndrome de intestino corto en el paciente pediátrico? Situación actual.
Alternate Title:	Is there anything new in treating pediatric patients with short bowel syndrome? State of the art.
Authors:	Aldana Grisales, A.¹, M. Moreno Villares, J.¹ Jmoreno.hdoc@salud.madrid.org
Source:	Acta Pediátrica Española. feb2011, Vol. 69 Issue 2, p67-74. 8p.
Subjects:	SHORT bowel syndrome, SMALL intestine surgery complications, GASTROENTEROLOGISTS, SOMATOTROPIN, NUTRITION
Abstract (English):	Short bowel syndrome is an uncommon condition leading to prolonged or permanent intestinal failure in unweaned babies and children. Until intestinal transplantation is available, most of these children required a long-term parenteral nutrition. In the last few years' new strategies have been developed for the management of short bowel syndrome patients. The implementation of multidisciplinary teams' composed of (gastroenterologist, surgeon, nutritionist, dietician, nurse) has significantly improved the outcomes of the intestinal failure. Criteria to foresee which patients will achieve nutritional adaptation have been implemented. Beside these actions, there have been changes in the way parenteral nutrition (low fat, omega 3 fatty acids) as enteral nutrition (early use, glutamine) is provided. New medical treatments have been applied, mainly growth factors. Two of them stand out: growth hormone and an analogue of glucagonlike peptide-2 have shown promising results. At the same time surgical small bowel lengthening procedures (Bianchi, STEPS) in well-selected cases help to avoid intestinal transplantation. If finally a severe complication of home parenteral nutrition appears and no further possibility exists, intestinal transplantation is a valuable option. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	El síndrome de intestino corto es una afección clínica poco frecuente, que origina un fallo intestinal prolongado o permanente en lactantes y niños. Hasta la disponibilidad del trasplante intestinal, muchos de estos niños requerían nutrición parenteral de forma prolongada o permanente. Sin embargo, en los últimos años se han desarrollado nuevas estrategias en el manejo de pacientes con síndrome de intestino corto. La creación de equipos multidisciplinarios compuestos por gastroenterólogos, cirujanos, nutricionistas, dietistas y enfermeras ha contribuido a mejorar los resultados en el tratamiento del fallo intestinal. Se han establecido criterios que permitan anticipar qué pacientes pueden llegar a alcanzar la adaptación intestinal. Junto con las medidas anteriores, se ha optimizado la forma en que se proporcionan tanto la nutrición parenteral (menor carga lipídica, uso de soluciones lipídicas con omega-3) como la nutrición enteral (empleo precoz, glutamina). También se dispone de fármacos, sobre todo factores de crecimiento, con resultados esperanzadores. Destacan fundamentalmente dos: la hormona del crecimiento y un análogo del péptido similar al glucagón tipo 2. Asimismo, el recurso a nuevos procedimientos de alargamiento intestinal (enteroplastia transversa seriada) o más clásicos (tipo Bianchi) ha contribuido a evitar, en casos seleccionados, el trasplante intestinal. Esta opción continúa siendo válida en los casos en que ninguna de las medidas anteriores funcione y se presenten complicaciones graves de la nutrición parenteral. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Short bowel syndrome is an uncommon condition leading to prolonged or permanent intestinal failure in unweaned babies and children. Until intestinal transplantation is available, most of these children required a long-term parenteral nutrition. In the last few years' new strategies have been developed for the management of short bowel syndrome patients. The implementation of multidisciplinary teams' composed of (gastroenterologist, surgeon, nutritionist, dietician, nurse) has significantly improved the outcomes of the intestinal failure. Criteria to foresee which patients will achieve nutritional adaptation have been implemented. Beside these actions, there have been changes in the way parenteral nutrition (low fat, omega 3 fatty acids) as enteral nutrition (early use, glutamine) is provided. New medical treatments have been applied, mainly growth factors. Two of them stand out: growth hormone and an analogue of glucagonlike peptide-2 have shown promising results. At the same time surgical small bowel lengthening procedures (Bianchi, STEPS) in well-selected cases help to avoid intestinal transplantation. If finally a severe complication of home parenteral nutrition appears and no further possibility exists, intestinal transplantation is a valuable option. [ABSTRACT FROM AUTHOR]
ISSN:	00016640