Intestinal Failure, Rehabilitation, and Transplantation

This presentation discusses the main aspects of managing pediatric patients with intestinal failure and/or short bowel syndrome. It provides a brief overview of the anatomy of the small bowel and common causes of short bowel syndrome and intestinal failure. It reviews key management strategies for enteral nutrition including selecting types of formula, formula additives and use of pharmacologic agents. It reviews the management of pediatric patients who require parenteral nutrition and/or IV fluid replacements. It discusses management of patients who require long-term central venous access, and common complications in patients with CVCs. Lastly, it describes the prevalence and outcome data of pediatric intestinal transplant in the U.S., describes indications for listing a patient for intestinal transplant and describes post-operative and long-term management of intestinal transplant patients.

• Understand the anatomy and function of the small bowel, the difference between short bowel syndrome and intestinal failure, and be familiar with common causes of both.
• Know the goals of intestinal rehabilitation, and be familiar with the different pharmacologic, nutritional, and surgical approaches of intestinal rehabilitation management.
• Understand the main aspects of managing a patient on parenteral nutrition.
• Describe common complications of managing a patient who requires long-term central venous access.
• Know how to prescribe a fluid replacement regimen for a patient with intestinal failure.
• Understand the definition of IFALD and explain several factors that contribute.
• Be familiar with indications for intestinal transplant and describe listing criteria.
• Understand post-operative management and acute and long-term monitoring of intestinal transplant patients.

Skyler Tomko has nothing to disclose.