Prevalence of home parenteral nutrition in children.


Journal

Clinical nutrition ESPEN
ISSN: 2405-4577
Titre abrégé: Clin Nutr ESPEN
Pays: England
ID NLM: 101654592

Informations de publication

Date de publication:
04 2021
Historique:
received: 20 10 2020
revised: 25 11 2020
accepted: 19 12 2020
entrez: 22 3 2021
pubmed: 23 3 2021
medline: 25 9 2021
Statut: ppublish

Résumé

Use of HPN in paediatrics in the UK has increased rapidly over the last 20 years but the prevalence of HPN has been challenging to define. Clinicians in the UK have noted an evolving complexity of cases and perceive improved outcomes and increased acceptability of long-term PN. These factors combined have the potential to increase the burden on existing paediatric gastroenterology services in the UK. A national database was interrogated to define the prevalence of HPN in children in the UK and to explore outcomes for patients receiving HPN. Since 2015, 525 children were notified to the database; of these patients, mortality was <5% and intestinal transplant occurred in 1%. In 2019, 389 children received HPN in the UK; this is nearly double the number last reported in 2012 and is a prevalence of 30 per million children. Short bowel syndrome is the largest category of these patients. However, a poorly defined group including those with multisystem disease has increased 10 fold since 2012 and is now the second largest category. Long term HPN in childhood is safe and associated with good survival and low risk of the need for intestinal transplantation.

Sections du résumé

BACKGROUND
Use of HPN in paediatrics in the UK has increased rapidly over the last 20 years but the prevalence of HPN has been challenging to define. Clinicians in the UK have noted an evolving complexity of cases and perceive improved outcomes and increased acceptability of long-term PN. These factors combined have the potential to increase the burden on existing paediatric gastroenterology services in the UK.
METHODS
A national database was interrogated to define the prevalence of HPN in children in the UK and to explore outcomes for patients receiving HPN.
RESULTS
Since 2015, 525 children were notified to the database; of these patients, mortality was <5% and intestinal transplant occurred in 1%. In 2019, 389 children received HPN in the UK; this is nearly double the number last reported in 2012 and is a prevalence of 30 per million children. Short bowel syndrome is the largest category of these patients. However, a poorly defined group including those with multisystem disease has increased 10 fold since 2012 and is now the second largest category.
CONCLUSIONS
Long term HPN in childhood is safe and associated with good survival and low risk of the need for intestinal transplantation.

Identifiants

pubmed: 33745567
pii: S2405-4577(21)00069-3
doi: 10.1016/j.clnesp.2020.12.029
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

138-141

Informations de copyright

Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest AEW has spoken at educational events for Fresenius Kabi and Shire/Takeda and received speakers fees. RR has no conflicts to declare. ARB has spoken at education events for Nutricia and Shire/Takeda, although he has received no personal fee. JT acted as a consultant for Shire/Takeda Pharmaceuticals with respect to Teduglutide during 2018. AB has spoken at educational events organised by Takeda.

Auteurs

Anthony E Wiskin (AE)

Department of Paediatric Gastroenterology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, UK. Electronic address: a.wiskin@nhs.net.

Rachel Russell (R)

Department of Paediatric Gastroenterology, Southampton Children's Hospital, Tremona Road, Southampton, SO16 6YD, UK.

Andrew R Barclay (AR)

Department of Paediatric Gastroenterology, Royal Hospital for Sick Children, Govan Road, Glasgow, G51 4TF, UK.

Julian Thomas (J)

Department of Paediatric Gastroenterology, Great North Children's Hospital, Royal Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK.

Akshay Batra (A)

Department of Paediatric Gastroenterology, Southampton Children's Hospital, Tremona Road, Southampton, SO16 6YD, UK.

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