Cernat Elena, Puntis John
Department of Paediatric Gastroenterology and Nutrition, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Frontline Gastroenterol. 2019 Jul 9;11(2):148-154. doi: 10.1136/flgastro-2018-101127. eCollection 2020 Mar.
Parenteral nutrition transformed the prognosis for infants and children with intestinal failure. Soon after its introduction into clinical care 50 years ago, parenteral nutrition was also rapidly adopted for use in the preterm infant, where immaturity of gastrointestinal motor function precluded enteral feeding. Preterm infants subsequently became the single largest group of patients to be fed in this way. Although the development of scientific knowledge and the lessons of clinical experience have reduced the risk of complications, some of the problems and difficulties associated with this form of nutritional support remain challenging. These include central venous catheter-related sepsis, thrombosis, liver disease, bone disease and metabolic disturbance. In an initiative to promote best practice, guidelines on parenteral nutrition were first published by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and collaborating organisations in 2005. These were constructed following a thorough review of the scientific literature, allowing a series of evidence-based recommendations to be made. The exercise was repeated just over 10 years later and updated guidelines published in 2018. This review summarises key elements from the new guideline, with a focus on what has changed since 2005.
肠外营养改变了患有肠衰竭的婴幼儿的预后。50年前肠外营养引入临床护理后不久，也迅速被用于早产儿，因为其胃肠运动功能不成熟，无法进行肠内喂养。早产儿随后成为以这种方式喂养的最大单一患者群体。尽管科学知识的发展和临床经验的教训降低了并发症的风险，但这种营养支持形式相关的一些问题和困难仍然具有挑战性。这些问题包括中心静脉导管相关的败血症、血栓形成、肝病、骨病和代谢紊乱。为了推广最佳实践，欧洲儿科胃肠病学、肝病学和营养学会及合作组织于2005年首次发布了肠外营养指南。这些指南是在对科学文献进行全面审查后制定的，从而能够提出一系列基于证据的建议。10多年后再次进行了这项工作，并于2018年发布了更新后的指南。本综述总结了新指南的关键要点，重点关注自2005年以来发生的变化。
