1
|
Romanowska H, Wilk A, Danko M, Borkowska A, Popińska K, Sibilska M, Żydak J, Marciniak W, Szlagatys-Sidorkiewicz A, Książyk J. Evaluation of Arsenic and Cobalt Levels in Pediatric Patients Receiving Long-Term Parenteral Nutrition. Nutrients 2024; 16:1179. [PMID: 38674871 PMCID: PMC11054380 DOI: 10.3390/nu16081179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
This study continues the research in which we determined the concentration of aluminum in children receiving long-term parenteral nutrition (LPN). Since our results were interesting, we decided to assay arsenic (As) and cobalt (Co) in the collected material, which, like aluminum, constitute contamination in the mixtures used in parenteral nutrition. Excesses of these trace elements in the human body are highly toxic, and deficiencies, particularly in the case of Co, can lead to various complications. The aim of this study was to determine the impact of LPN in children on their serum levels of As and Co, as well as the excretion of these elements in urine, and to compare them with a control group of healthy children. The study group consisted of 83 children receiving home parenteral nutrition from two Polish centers, while the control group included 121 healthy children. In both groups, the levels of As and Co in serum and urine were measured. The elemental compositions of the samples were determined using inductively coupled plasma mass spectrometry (ICP-MS). It was demonstrated that the children receiving LPN did not have increased As exposure compared to the controls. Greater exposure compared to the control group was shown for Co. In conclusion, children receiving LPN are not exposed to As, and even though the concentrations of Co in serum and urine were higher in the LPN group than in the healthy controls, neither trace element poses a health threat to children requiring LPN.
Collapse
Affiliation(s)
- Hanna Romanowska
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, 71-252 Szczecin, Poland
| | - Aleksandra Wilk
- Department of Histology and Embryology, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Mikołaj Danko
- The Children’s Memorial Health Institute, Department of Pediatrics, Nutrition and Metabolic Diseases, 04-730 Warsaw, Poland; (M.D.); (K.P.); (M.S.); (J.K.)
| | - Anna Borkowska
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Medical University of Gdańsk, 80-803 Gdańsk, Poland; (A.B.); (A.S.-S.)
| | - Katarzyna Popińska
- The Children’s Memorial Health Institute, Department of Pediatrics, Nutrition and Metabolic Diseases, 04-730 Warsaw, Poland; (M.D.); (K.P.); (M.S.); (J.K.)
| | - Marta Sibilska
- The Children’s Memorial Health Institute, Department of Pediatrics, Nutrition and Metabolic Diseases, 04-730 Warsaw, Poland; (M.D.); (K.P.); (M.S.); (J.K.)
| | - Joanna Żydak
- The Children’s Memorial Health Institute, Department of Pediatrics, Nutrition and Metabolic Diseases, 04-730 Warsaw, Poland; (M.D.); (K.P.); (M.S.); (J.K.)
| | - Wojciech Marciniak
- Department of Genetics and Pathology, Pomeranian Medical University, 71-252 Szczecin, Poland;
| | - Agnieszka Szlagatys-Sidorkiewicz
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Medical University of Gdańsk, 80-803 Gdańsk, Poland; (A.B.); (A.S.-S.)
| | - Janusz Książyk
- The Children’s Memorial Health Institute, Department of Pediatrics, Nutrition and Metabolic Diseases, 04-730 Warsaw, Poland; (M.D.); (K.P.); (M.S.); (J.K.)
| |
Collapse
|
2
|
Romanowska H, Bartoszewicz K, Danko M, Wielopolska J, Popińska K, Żydak J, Sibilska M, Borkowska A, Szlagatys-Sidorkiewicz A, Książyk J. Unexpected Serum and Urine Aluminum Concentrations in Pediatric Patients on Home Parenteral Nutrition. Nutrients 2023; 15:3597. [PMID: 37630787 PMCID: PMC10458977 DOI: 10.3390/nu15163597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/11/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023] Open
Abstract
The intravenous supply of aluminum (Al) present in parenteral nutrition solutions poses a high risk of the absorption of this element, which can result in metabolic bone disease, anemia, and neurological complications. The aim of this study is to determine the impact of long-term parenteral nutrition (PN) in children on serum Al concentration and its urinary excretion compared to healthy children. We evaluated serum Al concentrations and its urinary excretion in patients enrolled in the Polish home parenteral nutrition (HPN) program between 2004 and 2022. The study group included 83 patients and the control group consisted of 121 healthy children. In children whose PN was started in the neonatal period, we found higher serum Al concentrations and higher urinary Al excretion than in other subjects whose PN was started later. Only 12% of the children on chronic parenteral nutrition had serum Al concentrations of less than 5 μg/L. Healthy children in the control group had higher serum Al concentrations than those in the parenteral nutrition group, which may indicate the influence of one's environment and diet on Al serum levels.
Collapse
Affiliation(s)
- Hanna Romanowska
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (K.B.); (J.W.)
| | - Klaudia Bartoszewicz
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (K.B.); (J.W.)
| | - Mikołaj Danko
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland; (M.D.); (K.P.); (M.S.); (J.K.)
| | - Joanna Wielopolska
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland; (K.B.); (J.W.)
| | - Katarzyna Popińska
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland; (M.D.); (K.P.); (M.S.); (J.K.)
| | - Joanna Żydak
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland; (M.D.); (K.P.); (M.S.); (J.K.)
| | - Marta Sibilska
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland; (M.D.); (K.P.); (M.S.); (J.K.)
| | - Anna Borkowska
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Medical University of Gdansk, Nowe Ogrody 1-6, 80-803 Gdansk, Poland; (A.B.); (A.S.-S.)
| | - Agnieszka Szlagatys-Sidorkiewicz
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Medical University of Gdansk, Nowe Ogrody 1-6, 80-803 Gdansk, Poland; (A.B.); (A.S.-S.)
| | - Janusz Książyk
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland; (M.D.); (K.P.); (M.S.); (J.K.)
| |
Collapse
|
3
|
Wiernicka A, Matuszczyk M, Szlagatys-Sidorkiewicz A, Zagierski M, Toporowska-Kowalska E, Gębora-Kowalska B, Popińska K, Sibilska M, Grzybowska-Chlebowczyk U, Więcek S, Hapyn E, Blimke-Kozieł K, Kierkuś J. Analysis of frequency and risk factors for complications of enteral nutrition in children in Poland after percutaneous endoscopic gastrostomy placement. Nutrition 2021; 89:111265. [PMID: 34082251 DOI: 10.1016/j.nut.2021.111265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/08/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of the study was to assess the complication rate and identify whether age, nutritional status, and history of respiratory aspiration prior to percutaneous endoscopic gastrostomy (PEG) are risk factors for post-PEG placement complications in Polish children. In addition, the safety of two enteral feeding methods (3 h vs. 8 h) after PEG insertion in children was compared. METHODS Children with clinical indications for PEG placement were recruited from six medical centers in Poland to participate in the study. The patients were centrally randomized to receive the first bolus feed via a feeding tube at 3 h (group 1) or 8 h (group 2) after PEG placement. The preprocedural preparation, postoperative care, and resumption of feeding were performed on all of patients in accordance with the study protocol. Patients were followed for 12 mo. RESULTS Of the 97 randomized patients, 49 were assigned to group 1 and 48 to group 2. Full feed after PEG placement was achieved within 24 to 48 h in most cases (74% vs. 82%). There were no differences between the groups regarding the number of early mild (31.3% vs. 31.3%) and serious (2.1% vs 8.3%) complications or the duration of hospitalization after PEG placement (P > 0.05). The most common serious complication after PEG placement was accidental displacement of PEG. Most reported late complications were mild. The results of the regression analysis indicate no statistically significant effect of age, body mass index standard deviation score, white blood cell count, serum albumin level, and respiratory aspiration in the medical history on the occurrence of mild and severe complications. CONCLUSIONS The early initiation of post-PEG feeding was not associated with an increase in the number of complications. Most complications after the PEG procedure were mild. Age, serum albumin level, white blood cells, body mass index standard deviation score, and a history of aspiration to the respiratory tract were not confirmed as a risk factor for post-PEG complications in children.
Collapse
Affiliation(s)
- Anna Wiernicka
- Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland.
| | - Małgorzata Matuszczyk
- Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | | | - Maciej Zagierski
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Beata Gębora-Kowalska
- Department of Alergology, Gastroenterology and Nutrition, Medical University, Łódź, Poland
| | - Katarzyna Popińska
- Department of Pediatrics, Nutrition and Metabolic Disorders, The Children's Memorial Health Institute, Warsaw, Poland
| | - Marta Sibilska
- Department of Pediatrics, Nutrition and Metabolic Disorders, The Children's Memorial Health Institute, Warsaw, Poland
| | | | - Sabina Więcek
- Department of Pediatrics, Medical University of Silesia, Katowice, Poland
| | - Ewa Hapyn
- Department of Pediatrics and Gastroenterology, Area Hospital in Toruń, Poland
| | | | - Jarosław Kierkuś
- Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| |
Collapse
|
4
|
Danko M, Żyła-Pawlak A, Książyk J, Olszewska-Durkacz K, Sibilska M, Żydak J, Popińska K. A Retrospective Analysis of the Effect of Combination of Pure Fish Oil with Third Generation Lipid Emulsion on Liver Function in Children on Long-Term Parenteral Nutrition. Nutrients 2019; 11:nu11102495. [PMID: 31627315 PMCID: PMC6836066 DOI: 10.3390/nu11102495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/06/2019] [Accepted: 10/10/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Deterioration of liver function, or intestinal failure-associated liver disease, is often observed in long-term parenterally fed children. Fish oil-based intravenous lipids have been reported to play a role in the prevention and treatment of intestinal failure associated liver disease. METHODS This retrospective analysis included 40 pediatric patients, (20 male and 20 female), median age 38 months (range 1.5-200 months) on long-term (≥1 month) parenteral nutrition who received the parenteral mixtures containing a combination of a third-generation lipid emulsion and pure fish oil because of laboratory liver function abnormalities. The total dose of fish oil from both emulsions for each patient exceeded 0.5 g/kg/day. Data from visits in an outpatient clinic were retrospectively analyzed using the Wilcoxon test, Mann-Whitney test, and Spearman correlation test. RESULTS The median time of therapy was 149 days (range 28-418 days). There was a decrease of median total and direct (conjugated) bilirubin concentration from 22.23 µmol/L (range 3.42-243 µmol/L) to 10.26 µmol/L (range 3.42-180.58 µmol/L; p < 0.005) and 8.55 (range 1.71-212.04 µmol/L) to 6.84 µmol/L (range 1.71-150.48 µmol/L; p < 0.007) respectively. A significant decrease in median alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase was also observed. In 11 patients bilirubin concentrations increased or remained unchanged. When compared to the patients who responded to the combination therapy, the patients who did not respond received parenteral nutrition for a longer time prior to the start of the therapy (51 vs. 30 months; p < 0.05). CONCLUSIONS The mixture of an intravenous lipid emulsion containing soybean oil, medium-chain triglycerides, olive oil, and fish oil with the addition of pure fish oil emulsion may be helpful in the treatment of liver complications in children on long-term parenteral nutrition.
Collapse
Affiliation(s)
- Mikołaj Danko
- Department of Paediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Al. Dzieci Polski 20, 04-730 Warsaw, Poland.
| | - Aleksandra Żyła-Pawlak
- Department of Paediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Al. Dzieci Polski 20, 04-730 Warsaw, Poland.
| | - Janusz Książyk
- Department of Paediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Al. Dzieci Polski 20, 04-730 Warsaw, Poland.
| | - Katarzyna Olszewska-Durkacz
- Department of Paediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Al. Dzieci Polski 20, 04-730 Warsaw, Poland.
| | - Marta Sibilska
- Department of Paediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Al. Dzieci Polski 20, 04-730 Warsaw, Poland.
| | - Joanna Żydak
- Department of Paediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Al. Dzieci Polski 20, 04-730 Warsaw, Poland.
| | - Katarzyna Popińska
- Department of Paediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Al. Dzieci Polski 20, 04-730 Warsaw, Poland.
| |
Collapse
|
5
|
Danko M, Żyła-Pawlak A, Popińska K, Sibilska M, Olszewska K, Żydak J, Janiec A, Książyk J. OR57: Intravenous Iron Supplementation in Children with Intestinal Failure on Home Parenteral Nutrition. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32529-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
6
|
Wiernicka A, Matuszczyk M, Szlagatys-Sidorkiewicz A, Landowski P, Toporowska-Kowalska E, Gębora-Kowalska B, Popińska K, Sibilska M, Grzybowska-Chlebowczyk U, Więcek S, Hapyn E, Blimke-Kozieł K, Kierkuś J. Tolerability and safety of early enteral nutrition in children after percutaneous endoscopic gastrostomy placement: A multicentre randomised controlled trial. Clin Nutr 2019; 38:1544-1548. [DOI: 10.1016/j.clnu.2018.08.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 08/02/2018] [Accepted: 08/20/2018] [Indexed: 01/27/2023]
|
7
|
Tobota K, Popińska K, Danko M, Żydak J, Sibilska M, Olszewska K, Książyk J. Analysis of patients with pseudo-obstruction syndrome in home parenteral nutrition (HPN) program in warsaw. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
8
|
Tobota K, Popińka K, Danko M, Olszewska K, Sibilska M, Zydak J, Ksiazyk J. SUN-P262: Analysis of Factors Conducive to Weaning off Home Parenteral Nutrition Program in Children In 2014–2016. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30367-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
9
|
Zyla-Pawlak A, Danko M, Popińska K, Sibilska M, Olszewska K, Żydak J, Książyk J. OR44: Iron Deficiency Anemia in Children in Home Parenteral Nutrition Programme. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30743-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
10
|
Szlagatys-Sidorkiewicz A, Borkowska A, Popińska K, Toporowska-Kowalska E, Grzybowska-Chlebowczyk U, Wernicka A, Hapyn E, Sibilska M, Gębora-Kowalska B, Więcek S, Zagożdżon P, Kierkuś J. Complications of PEG are not related to age - The result of 10-year multicenter survey. Adv Med Sci 2016; 61:1-5. [PMID: 26342669 DOI: 10.1016/j.advms.2015.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 06/12/2015] [Accepted: 07/24/2015] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of this study was to analyze whether the insertion of Percutaneous Endoscopic Gastrostomy (PEG) during infancy is related to higher morbidity. Moreover, we analyzed the structure of indications to PEG placement in various age groups of pediatric patients. MATERIAL/METHODS The study involved medical data of children after PEG insertion from six Polish endoscopic centers: infants (<12 months of age), toddlers (12-36 months), and preadolescents (>36 months). RESULTS The overall prevalence of early complications associated with PEG insertion was 5.14%; while they were noted in infants and preadolescents, none were recorded in toddlers. The analyzed age groups did not differ significantly in terms of the prevalence of late complications. Cerebral palsy (34.86%) and other chronic neurological conditions (34.29%) were the most frequent indications to PEG insertion in the whole group. Patients with congenital heart defects and multiple defect syndrome were inserted PEG at the youngest age; in contrast, the age at insertion was the highest in cystic fibrosis patients. CONCLUSIONS The early qualification to nutritional intervention via endoscopically formed gastrostomy can have important clinical implications with regards to improved therapeutic outcomes and reduced morbidity rates.
Collapse
|
11
|
Żyła A, Sibilska M, Danko M, Popińska K, Sobolewska A, Świeboda O, Śnieć D, Książyk J. MON-PP099: Growth and Nutrition in Children with Cerebral Palsy on Home Enteral Nutrition Programme (2 Years Observation). Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30531-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
12
|
Danko M, Żyła A, Pąśko E, Książyk J, Popińska K, Sibilska M, Olszewska K, Żydak J. OR051: Impact of Lipid Emulsion Containing Soy-Bean Oil, Olive Oil, Medium-Chain Triglycerides and Fish Oil on Parenteral Nutrition Associated Liver Disease (PNALD) in Children with Intestinal Failure During First 6 Months of Home Parenteral Nutrition. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30151-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
13
|
Szlagatys-Sidorkiewicz A, Popińska K, Toporowska-Kowalska E, Borkowska A, Sibilska M, Gębora-Kowalska B, Kłęk S, Hapyn E, Kierkuś J, Grzybowska-Chlebowczyk U, Więcek S, Daukszewicz A, Jakubczyk M, Lembas-Sznabel M, Wilczyński M, Zagożdżon I, Matras P, Zmarzly A, Książyk J. Home enteral nutrition in children--2010 nationwide survey of the Polish Society for Clinical Nutrition of Children. Eur J Pediatr 2012; 171:719-23. [PMID: 22170237 PMCID: PMC3306559 DOI: 10.1007/s00431-011-1646-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 11/29/2011] [Indexed: 12/04/2022]
Abstract
Published epidemiologic data on the administration rates of enteral/parenteral home nutrition is very limited. The aim of this first nationwide study was to assess the availability of pediatric home enteral nutrition (HEN) services in Poland. The questionnaire was sent to all regional centers providing pediatric HEN services in Poland (n = 14). The analysis included the number of pediatric patients who received HEN in 2010, their demographic characteristics and geographical distribution. Furthermore, the distributions of indications and methods of enteral nutrition administration were analyzed, along with the reasons of withdrawal from the HEN program. The number and fraction of children receiving HEN increased in 2010, from 433 (11.34 per 1 million inhabitants) on January 1st to 525 (13.75) on December 31st. Marked differences were observed in geographical distribution of this parameter, from zero to up to 30 pediatric patients per 1 million inhabitants. Median age of patients was 6 years (range: 9 months-18 years). In most cases, HEN was prescribed due to neurological disorders (n = 337, 64.2%), and administered by means of gastrostomy (n = 450, 85.71%). This study revealed the dynamic development of pediatric HEN services in Poland but also documented their potential regional shortages.
Collapse
Affiliation(s)
- Agnieszka Szlagatys-Sidorkiewicz
- Department of Pediatrics, Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk, ul. Nowe Ogrody 1-6, 80-03, Gdansk, Poland.
| | - Katarzyna Popińska
- Department of Pediatrics, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Ewa Toporowska-Kowalska
- Department of Allergology, Gastroenterology and Nutrition, Medical University of Lodz, Lodz, Poland
| | - Anna Borkowska
- Department of Pediatrics, Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk, ul. Nowe Ogrody 1-6, 80-03 Gdansk, Poland
| | - Marta Sibilska
- Department of Pediatrics, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Beata Gębora-Kowalska
- Department of Allergology, Gastroenterology and Nutrition, Medical University of Lodz, Lodz, Poland
| | | | - Ewa Hapyn
- Department of Pediatrics and Gastroenterology, Area Hospital in Torun, Torun, Poland
| | - Jarosław Kierkuś
- Department of Gastroenterology, Hepatology and Immunology, The Children’s Memorial Institute, Warsaw, Poland
| | | | - Sabina Więcek
- Department of Pediatrics, Silesian Medical Academy, Katowice, Poland
| | | | - Marlena Jakubczyk
- Clinic for Home Enteral and Parenteral Nutrition, Department of Anesthesiology and Intensive Therapy, Collegium Medicum of Bydgoszcz, Nicolaus Copernicus University in Torun, Torun, Poland
| | | | | | - Ilona Zagożdżon
- Department of Nephrology and Hypertension, Medical University of Gdansk, Gdansk, Poland
| | - Przemysław Matras
- 1st Department of Surgery, Transplantology and Nutrition, Medical University in Lublin, Lublin, Poland
| | - Anna Zmarzly
- Home Enteral Nutrition Clinic, Area Hospital, Wroclaw, Poland
| | - Janusz Książyk
- Department of Pediatrics, The Children’s Memorial Health Institute, Warsaw, Poland
| |
Collapse
|
14
|
Błońska M, Friedman-Gruszczyńska J, Sibilska M, Laskowska J, Wesół-Kucharska D, Gawecka A, Ksiazyk J. [Treatment of gastro-esophageal reflux in children and premature infants]. Med Wieku Rozwoj 2008; 12:912-923. [PMID: 19471067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Gastroesophageal reflux is a common problem in the paediatric population, which affects especially infants, neonates and preterm infants. Usually the course is benign, but it can also be a cause of severe complications and acute life threatening events. In this paper diagnostic methods are presented and a systematic literature review of treatment options is given. Current recommendations are proposed according to the results of this review.
Collapse
Affiliation(s)
- Magdalena Błońska
- Klinika Pediatrii Instytut Pomnik-Centrum Zdrowia Dziecka, 04-730 Warszawa, Poland
| | | | | | | | | | | | | |
Collapse
|
15
|
Wesół-Kucharska D, Laskowska J, Sibilska M, Friedman-Gruszczyńska J, Błońska M, Gawecka A, Czech-Kowalska J, Dobrzańska A, Ksiazyk J, Swietliński J. [Prevention of osteopenia in premature infants]. Med Wieku Rozwoj 2008; 12:924-932. [PMID: 19471068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Proposition of recommendations for prevention of osteopenia in premature infants is presented in this article. In parenteral nutrition in premature infants calcium and phosphorus should be supplemented early in a dose of 80-100 mg/kg/24 h (2-2.5 mmol/kg/24 h) and 43-63 mg/kg/24 h (1.4-2 mmol/kg/24 h) respectively. In enteral nutrition calcium and phosphorus should be supplemented in a dose 90-150 mg/kg/24 h (2.25-3.7 mmol/kg/24 h), and: 45-80 mg/kg/24 h (1.5-2.6 mmol/kg) respectively. Breast milk fortifier is recommended up to the corrected age of 40 Hbd and in case of growth retarded infants - up to 52 Hbd. Vitamin D should be supplemented in a dose of 400-800 IU, particularly in breast fed infants. Vitamin content in formula or fortifier must be taken into account. Active metabolites of vitamin D are not recommended. Physical activities, together with appropriate mineral, protein and energy intake may decrease the risk of osteopenia. Laboratory assessment of calcium and phosphorus homeostasis is recommended every 2 weeks, from 6(th) week of life.
Collapse
MESH Headings
- Bone Diseases, Metabolic/blood
- Bone Diseases, Metabolic/diagnosis
- Bone Diseases, Metabolic/prevention & control
- Breast Feeding
- Calcium/blood
- Enteral Nutrition/methods
- Humans
- Infant, Newborn
- Infant, Premature, Diseases/blood
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/prevention & control
- Monitoring, Physiologic
- Parenteral Nutrition/methods
- Phosphorus/blood
- Practice Guidelines as Topic
Collapse
|