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Nutritional Requirements and Enteral/Parenteral Nutrition in Pediatric Care

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: closed (15 October 2024) | Viewed by 5702

Special Issue Editor


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Guest Editor
Department of Pediatrics, Nutrition, and Metabolic Diseases, Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland
Interests: medical nutrition; prevention of cholestasis; ordering parenteral nutrition; home parenteral nutrition; home enteral nutrition

Special Issue Information

Dear Colleagues,

This Special Issue of NUTRIENTS aims to present new findings on patients who need to be fed parenterally or by a gastrointestinal route.

Parenteral nutrition (PN) is one of the most significant advances in modern medicine, providing a life-sustaining option in situations where adequate oral or enteral nutrition is unavailable due to impaired gastrointestinal function. PN is a life-saving therapy for patients with bowel insufficiency and Short Bowel Syndrome (SBS) who need it throughout their lives. There is something passionate about the fact that entirely non-physiological substrate delivery via the parenteral route can live and allows, in the case of long-term home feeding, regular activity and only slightly reduces the quality of life. The advances in formulations and venous access have reduced the risk of complications.

Continued progress in enteral nutrition is also significant. Recent evidence has suggested that enteral nutrition may alter the composition of the gut microbiome, which plays an essential role in the pathogenesis of inflammatory bowel disease and cancer development/treatment, among others. Home enteral nutrition is also necessary regarding patient health, quality of life, and cost reductions for the healthcare system. However, progress has yet to be made, which continues all the time, and it is a challenge for us to keep track of discoveries and experiences that can be applied to medical practice.

We hope that the publications presented here will contribute to a better understanding of the problems behind medical nutrition and increase the use of this procedure in children who would be deprived under the conditions of their disease to survive and live.

Prof. Dr. Janusz Ksiazyk
Guest Editor

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Keywords

  • parenteral nutrition
  • enteral nutrition
  • preterm infants
  • intensive care
  • chronic intestinal failure

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Published Papers (3 papers)

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Research

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18 pages, 2122 KiB  
Article
Metabolomic Alterations of Volatile Organic Compounds and Bile Acids as Biomarkers of Microbial Shifts in a Murine Model of Short Bowel Syndrome
by Vanessa Wolfschluckner, Beate Obermüller, Angela Horvath, Giovanny Rodriguez-Blanco, Patricia Fuchs, Wolfram Miekisch, Barbara Mittl, Christina Flucher, Holger Till and Georg Singer
Nutrients 2023, 15(23), 4949; https://doi.org/10.3390/nu15234949 - 29 Nov 2023
Cited by 1 | Viewed by 1724
Abstract
Pediatric short bowel syndrome (SBS) is a rare condition characterized by a massive loss of the small intestine, leading to the inability to meet nutritional requirements without the use of parenteral or enteral supplementation. SBS causes profound alterations in the intestinal microbiome and [...] Read more.
Pediatric short bowel syndrome (SBS) is a rare condition characterized by a massive loss of the small intestine, leading to the inability to meet nutritional requirements without the use of parenteral or enteral supplementation. SBS causes profound alterations in the intestinal microbiome and metabolome. The aim of this study was a detailed assessment of the intestinal microbiome and metabolome in a murine model of SBS. We performed a 60% proximal small bowel resection versus a sham operation in C57BL/6 mice. Four weeks postoperatively, the microbial communities of different intestinal segments (jejunum, ileum, colon) and stool were assessed by 16S rRNA gene sequencing. Bile acids in serum and stool and volatile organic compounds (VOCs) in the fecal headspace were assessed using LC-MS and GC-MS techniques. The α-diversity of the different intestinal segments did not significantly differ between the two groups. β-diversity significantly differed between sham and SBS mice. While in the jejunum, Faecalibaculum was significantly increased in SBS animals, a significant reduction in Lactobacillus and Sporosarcina was detected in the ileum of SBS mice. In the colon of SBS mice, a significant decrease in Ruminococcaceae and a significant increase in Proteobacteria such as Faecalibaculum and Escherichia-Shigella were found. Serum levels of deoxycholic, taurocholic and taurochenodeoxycholic acids were significantly higher in the SBS group. Of the 29 VOCs tested, hexane, isoflurane and pentane were significantly higher in the SBS group, and pyrrole was significantly lower. We were able to show that SBS causes shifts in the murine intestinal microbiome and metabolome including serum BAs and fecal VOCs. Full article
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Review

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17 pages, 9828 KiB  
Review
Congenital Diarrhoeas and Enteropathies
by Jutta Köglmeier and Keith James Lindley
Nutrients 2024, 16(17), 2971; https://doi.org/10.3390/nu16172971 - 3 Sep 2024
Cited by 1 | Viewed by 1744
Abstract
Congenital diarrhoeas and enteropathies (CODE) are a heterogeneous group of disorders. Many affected infants present with catastrophic dehydration in the first few days of life, although the clinical phenotype is variable. Advances in the understanding of underlying pathomechanisms and genetic testing, as well [...] Read more.
Congenital diarrhoeas and enteropathies (CODE) are a heterogeneous group of disorders. Many affected infants present with catastrophic dehydration in the first few days of life, although the clinical phenotype is variable. Advances in the understanding of underlying pathomechanisms and genetic testing, as well as improved management, in particular intravenous nutrition support, have allowed affected patients to survive well beyond childhood. Awareness and understanding of these rare diseases are hence needed, both amongst paediatricians and adult physicians. In this review, we discuss the different groups of disorders based on a review of the current literature and provide a diagnostic and therapeutic approach. Many of the subtypes of CODE result in the need for prolonged or indefinite parenteral nutrition. Further research is needed to identify new CODE to improve the recognition and management of these children, which can assist in developing new targeted therapies and potentially a long-term cure. Full article
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11 pages, 233 KiB  
Review
A Systematic Review of Clinical Practice Guidelines on the Management of Malnutrition in Children with Congenital Heart Disease
by Maciej Kołodziej and Julia Skulimowska
Nutrients 2024, 16(16), 2778; https://doi.org/10.3390/nu16162778 - 20 Aug 2024
Viewed by 1507
Abstract
Congenital heart disease (CHD) is one of the most common inborn disorders, with a prevalence of 0.8–1.2%. Affected children are often malnourished due to increased dietary requirements. This may lead to severe long-term complications. Several authoritative organizations have published guidelines addressing nutritional intervention [...] Read more.
Congenital heart disease (CHD) is one of the most common inborn disorders, with a prevalence of 0.8–1.2%. Affected children are often malnourished due to increased dietary requirements. This may lead to severe long-term complications. Several authoritative organizations have published guidelines addressing nutritional intervention in children with CHD. We aimed to systematically assess the consistency of recommendations, the methodological quality of these guidelines, and the quality of evidence supporting each recommendation. PubMed, Embase, the Cochrane Database, World Health Organization Global Index Medicus, and 16 scientific societies’ websites were searched for the period until September 2023. The guideline quality was assessed using the AGREE II tool. After screening 765 records, only 2 guidelines published in 2013 and 2022 met our inclusion criteria. The main reason for exclusion was the absence of any system for rating the evidence. The main issues concerned the lack of implementation advice or tools and the lack of criteria to measure the application of guideline recommendations. The included guidelines were of good quality and within specific recommendations, both publications were largely in agreement, and the score for the overall assessment was high (83%). There is a pressing need for comprehensive, multi-threaded guidelines incorporating implementation strategies and methods for the performance assessment of children with malnutrition and CHD. Full article
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