Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May;80(5):880-888.
doi: 10.1002/jpn3.70018. Epub 2025 Feb 18.

Nutritional management and outcomes of malnourished children under 2 years with intestinal failure

Estela Cristina Pavanelli  1   2   3 , Joao Seda Neto  1   2   3 , Beatriz Camilo Farah  1   2   3 , Roberta Luiza Longo  1   2   3 , Natália Canale Person  1   2   3 , Catiana Mitica Gritti  1   2   3 , Carine Dias Ferreira de Jesus  1   2   3 , Camila Mascarenhas Teixeira de Carvalho  1   2   3 , Massami Hayashi  1   2 , Catherina Oliveira Gameiro  1   2   3 , Jackeline Farias Brufato  1   2   3 , Gabrielle Marques Blini  1   2 , Rodrigo Vincenzi  1   2   3
Affiliations

Nutritional management and outcomes of malnourished children under 2 years with intestinal failure

Estela Cristina Pavanelli et al. J Pediatr Gastroenterol Nutr. 2025 May.

Abstract

Objective: This study aimed to assess the evolution of nutritional status, parenteral nutrition (PN) composition, and PN dependence index (PNDI) in children under 2 years old with intestinal failure (IF) and malnutrition.

Methods: This retrospective cohort included patients admitted between November 1, 2016, and August 31, 2021, with IF, age ≤24 months, and weight-for-age (Wt/A) <-2 standard deviation with a follow-up of 12 months. Data collected included demographic, anthropometric, biochemical, and nutritional information. The PNDI was compared between enteral autonomy (EA) and nonenteral autonomy (non-EA) groups.

Results: Thirty patients (16 males, 53.33%) were included, and short bowel syndrome (SBS) was the leading cause of IF (n = 27, 90%). The mean age at admission was 7.23 ± 3.90 months, and 36.66% of the patients had a conjugated bilirubin (CB) level >2 mg/dL; 87% had a Wt/A z-score <-3 and 90% had a height-for-age (Ht/A) z-score <-3. At 5 months, the mean Wt/A z-score improved to -1.82. At admission, median protein, lipid, and glucose intake on PN were 3, 1.6, and 17.27 g/kg/day, respectively. In the PNDI analysis, the EA group had a mean index of 141% versus 158% for the non-EA group at admission, with no statistical differences. From the sixth month onward, the EA group showed a significantly lower PNDI (50% vs. 108% for non-EA patients; p = 0.032). Both groups demonstrated adequate nutritional recovery.

Conclusion: Adequate multidisciplinary care can reverse severe malnutrition, and the PNDI may be a predictor of EA.

Keywords: intestinal rehabilitation; malnutrition; parenteral nutrition; short bowel syndrome.

PubMed Disclaimer

References

REFERENCES

    1. De Sanctis V, Soliman A, Alaaraj N, Ahmed S, Alyafei F, Hamed N. Early and long‐term consequences of nutritional stunting: from childhood to adulthood. Acta Biomed. 2021;92(1):e2021168.
    1. Modi BP, Galloway DP, Gura K, et al. ASPEN definitions in pediatric intestinal failure. J Parenter Enteral Nutr. 2022;46(1):42‐59.
    1. Squires RH, Duggan C, Teitelbaum DH, et al. Natural history of pediatric intestinal failure: initial report from the pediatric intestinal failure consortium. J Pediatr. 2012;161(4):723‐728.e2.
    1. Modi BP, Langer M, Ching YA, et al. Improved survival in a multidisciplinary short bowel syndrome program. J Pediatr Surg. 2008;43(1):20‐24.
    1. Diamond IR, de Silva N, Pencharz PB, Kim JH, Wales PW. Neonatal short bowel syndrome outcomes after the establishment of the first Canadian multidisciplinary intestinal rehabilitation program: preliminary experience. J Pediatr Surg. 2007;42(5):806‐811.

Grants and funding

LinkOut - more resources