Skip to main content
SpringerLink
Log in

Is neurodevelopment impaired in Brazilian children with intestinal failure on prolonged parenteral nutrition? A single center study

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Purpose

To assess the neurodevelopment outcomes of children younger than 42 months of age with intestinal failure (IF) using prolonged parenteral nutrition (PN) followed by a Pediatric Multidisciplinary Intestinal Rehabilitation Program from a public tertiary hospital in Brazil.

Methods

Bayley III scale was administered in children aged 2 to 42 months with IF and receiving PN for more than 60 days. Composite scores in cognitive, motor, and language domains were analyzed. Developmental delay was defined as a performance 2 standard deviations (SD) below the average at the 3 domains. Association between Bayley III composite scores and clinical variables related to IF were tested.

Results

Twenty-four children with median (IQR) age of 17.5 months (9–28.5) were studied, 58.3% were male. Developmental delay was found in 34%, 33% and 27% of the patients in cognitive, motor, and language domains, respectively. There was no significant association between the Bayley-III composite scores and length of hospitalization, prematurity, and number of surgical procedures with anesthesia.

Conclusion

The study demonstrated impairments in the cognitive, motor and language domains in approximately one-third of young patients with IF on prolonged PN.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

Requests for data sharing will be considered upon written request to the corresponding author.

References

  1. Belza C, Wales PW (2020) Multidisciplinary management in pediatric ultrashort bowel syndrome. J Multidiscip Healthc 13:9–17. https://doi.org/10.2147/JMDH.S236130

    Article  PubMed  PubMed Central  Google Scholar 

  2. Goldani HAS, Ceza MR, Godoy LL et al (2022) Outcomes of the first 54 pediatric patients on long-term home parenteral nutrition from a single Brazilian center. J Pediatr Gastroenterol Nutr 75:104–109. https://doi.org/10.1097/MPG.0000000000003473

    Article  PubMed  PubMed Central  Google Scholar 

  3. Modi BP, Galloway DP, Gura K et al (2022) ASPEN definitions in pediatric intestinal failure. JPEN J Parenter Enteral Nutr 46:42–59. https://doi.org/10.1002/jpen.2232

    Article  PubMed  Google Scholar 

  4. Lezo A, Diamanti A, Marinier EM et al (2022) Chronic intestinal failure in children: an international multicenter cross-sectional survey. Nutrients. https://doi.org/10.3390/nu14091889

    Article  PubMed  PubMed Central  Google Scholar 

  5. Fullerton BS, Sparks EA, Hall AM et al (2016) Enteral autonomy, cirrhosis, and long term transplant-free survival in pediatric intestinal failure patients. J Pediatr Surg 51:96–100. https://doi.org/10.1016/j.jpedsurg.2015.10.027

    Article  PubMed  Google Scholar 

  6. Duggan CP, Jaksic T (2017) Pediatric intestinal failure. N Engl J Med 377:666–675. https://doi.org/10.1056/NEJMra1602650

    Article  CAS  PubMed  Google Scholar 

  7. Mangalat N, Teckman J (2018) Pediatric intestinal failure review. Children 5:100. https://doi.org/10.3390/children5070100

    Article  PubMed  PubMed Central  Google Scholar 

  8. So S, Patterson C, Gold A et al (2016) Early neurodevelopmental outcomes of infants with intestinal failure. Early Hum Dev 101:11–16. https://doi.org/10.1016/j.earlhumdev.2016.05.012

    Article  PubMed  Google Scholar 

  9. So S, Patterson C, Gold A et al (2019) Neurodevelopmental outcomes of infants with intestinal failure at 12 and 26 months corrected age. Early Hum Dev 130:38–43. https://doi.org/10.1016/j.earlhumdev.2018.12.020

    Article  PubMed  Google Scholar 

  10. So S, Patterson C, Evans C, Wales PW (2019) Motor proficiency and generalized self-efficacy toward physical activity in children with intestinal failure. J Pediatr Gastroenterol Nutr 68:7–12. https://doi.org/10.1097/MPG.0000000000002107

    Article  PubMed  Google Scholar 

  11. Del Rosario C, Slevin M, Molloy EJ et al (2021) How to use the Bayley scales of infant and toddler development. Arch Dis Child Educ Pract Ed 106:108–112. https://doi.org/10.1136/archdischild-2020-319063

    Article  PubMed  Google Scholar 

  12. Bayley N (2018) Bayley scales of infant and toddler development Technical manual, 3rd edn. Pearson Clinical Brasil, São Paulo

    Google Scholar 

  13. Bayley N (2018) Bayley scales of infant and toddler development Administration manual, 3rd edn. Pearson Clinical Brasil, São Paulo

    Google Scholar 

  14. Madaschi V, Mecca TP, Macedo EC, Paula CS (2016) Bayley-III scales of infant and toddler development: transcultural adaptation and psychometric properties. Paideia 26:189–197. https://doi.org/10.1590/1982-43272664201606

    Article  Google Scholar 

  15. Gold A, Danguecan A, Belza C et al (2020) Neurocognitive functioning in early school-age children with intestinal failure. J Pediatr Gastroenterol Nutr 70:225–231. https://doi.org/10.1097/MPG.0000000000002500

    Article  PubMed  Google Scholar 

  16. Vlug LE, Verloop MW, Dierckx B et al (2022) Cognitive outcomes in children with conditions affecting the small intestine: a systematic review and meta-analysis. J Pediatr Gastroenterol Nutr 74:368–376. https://doi.org/10.1097/MPG.0000000000003368

    Article  PubMed  Google Scholar 

  17. Chesley PM, Sanchez SE, Melzer L et al (2016) Neurodevelopmental and cognitive outcomes in children with intestinal failure. J Pediatr Gastroenterol Nutr 63:41–45. https://doi.org/10.1097/MPG.0000000000001067

    Article  PubMed  PubMed Central  Google Scholar 

  18. Fox SE, Levitt P, Nelson CA (2010) How the timing and quality of early experiences influence the development of brain architecture. Child Dev. 81:28–40. https://doi.org/10.1111/j.1467-8624.2009.01380.x

    Article  PubMed  PubMed Central  Google Scholar 

  19. Mangin KS, Horwood LJ, Woodward LJ (2017) Cognitive development trajectories of very preterm and typically developing children. Child Dev 88:282–298. https://doi.org/10.1111/cdev.12585

    Article  PubMed  Google Scholar 

  20. Maggi EF, Magalhães LC, Campos AF, Bouzada MCF (2014) Preterm children have unfavorable motor, cognitive, and functional performance when compared to term children of preschool age. J Pediatr (Rio J) 90:377–383. https://doi.org/10.1016/j.jped.2013.10.005

    Article  PubMed  Google Scholar 

  21. Bell M, Cole CR, Hansen NI et al (2020) Neurodevelopmental and growth outcomes of extremely preterm infants with short bowel syndrome. J Pediatr 230:76-83.e5. https://doi.org/10.1016/j.jpeds.2020.11.026

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lo E, Kalish BT (2023) Neurodevelopmental outcomes after neonatal surgery. Pediatr Surg Int. https://doi.org/10.1007/s00383-022-05285-x

    Article  PubMed  Google Scholar 

  23. Sakurai T, Nakamura M, Sasaki H et al (2023) Risk factors for catheter-related bloodstream infections in patients with intestinal failure undergoing home parenteral nutrition: a single-center study. Pediatr Surg Int. https://doi.org/10.1007/s00383-023-05555-2

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We are grateful to all participating children and their families for dedicating their valuable time to this study. We also appreciate the valuable contribution of the multiprofessional team from the local Program of Intestinal Rehabilitation.

Funding

This study was supported by Fundo Nacional da Saúde, Ministry of Health; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES) and FIPE—Hospital de Clinicas de Porto Alegre.

Author information

Authors and Affiliations

  1. Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Cristina Miller, Bruna Ziegler, Letícia Feldens, Marília R. Ceza, Marina R. Adami, Carlos O. Kieling & Helena A. S. Goldani

  2. Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Renata R. Kieling, Alana V. Signorini & Giovana Q. Pires

  3. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    Juliana M. Giesta

Authors
  1. Cristina Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Renata R. Kieling
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bruna Ziegler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Juliana M. Giesta
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alana V. Signorini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giovana Q. Pires
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Letícia Feldens
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marília R. Ceza
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Marina R. Adami
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Carlos O. Kieling
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Helena A. S. Goldani
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

CM, RRK, HASG participated in the conception and design of the study. CM, BZ, JMG, AVS, GQP, LF, MRC, MRA, COK participated in the data collection. CM, RRK, COK, HASG participated in analysis and interpretation of data. CM and HASG produced the first draft of the manuscript and all authors were involved in producing the final version and approved its content.

Corresponding author

Correspondence to Cristina Miller.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miller, C., Kieling, R.R., Ziegler, B. et al. Is neurodevelopment impaired in Brazilian children with intestinal failure on prolonged parenteral nutrition? A single center study. Pediatr Surg Int 40, 120 (2024). https://doi.org/10.1007/s00383-024-05694-0

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00383-024-05694-0

Keywords

Search

Navigation