Date of Award

Summer 8-8-2018

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Nutrition

First Advisor

Dr. Anita Nucci

Second Advisor

Barbara Hopkins

Third Advisor

Jessica White

Abstract

Objective: To evaluate the difference in time to achieve enteral autonomy, survival, and linear growth velocity by parenteral nutrition (PN) weaning strategy in children with intestinal failure. Methods: Analysis of retrospectively reviewed medical record data included comparison of time to PN wean since the date of the first clinic visit, survival time, and differences in height z-scores between PN wean and two-years post-wean by whether an enteral tube feeding (TF) was used during the weaning process. Results: 32 of 49 children (65%) received an enteral TF with or without oral diet during the two-year follow-up period. Median time to weaning did not differ significantly between those who received a TF (21.5 months [IQR;10.3, 37.8]) vs. oral diet alone (19.0 months [IQR; 14.5, 40.0]). The probability of survival did not differ by TF status with only one death in the TF group. Linear growth velocity between the time of PN weaning to two-years post-wean did not significantly differ by TF status. Children who weaned via oral diet alone had a similar decrease in height z-score vs. those who received a TF (-0.14 vs. -0.15, respectively); however, a greater increase in z-score between years 1 and 2 post-wean was observed (+0.27 vs. +0.11, respectively). Conclusions: No association between weaning strategy and outcomes in children with IF was observed. Linear growth velocity declines during the first year after PN weaning but rebounds in year two. Future studies should examine the long-term benefits of oral feeding vs. TF on intestinal adaptation.

Available for download on Tuesday, June 25, 2019

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