Nutritional management of high‐output ileostomies in paediatric patients is vital and more evidence‐based guidelines are needed

Aim Paediatric patients with high‐output ileostomies (HOI) face an elevated risk of complications. This study aimed to comprehensively review the existing literature and offer nutritional management recommendations for paediatric patients with an HOI. Methods PubMed and Embase were searched for rele...

Full description

Saved in:

Bibliographic Details
Published in:	Acta Paediatrica 2024-05, Vol.113 (5), p.861-870
Main Authors:	Awouters, Marijke, Vanuytsel, Tim, Huysentruyt, Koen, De Bruyne, Pauline, Van Hoeve, Karen, Hoffman, Ilse
Format:	Article
Language:	eng
Subjects:	Adult Carbohydrates Child complications Dehydration Diet Electrolytes Energy Intake high‐output Humans Ileostomy Ileostomy - adverse effects Infant, Newborn intestinal failure Neonates Nutrient deficiency nutritional management Ostomy Pediatrics
Online Access:	Request full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Aim Paediatric patients with high‐output ileostomies (HOI) face an elevated risk of complications. This study aimed to comprehensively review the existing literature and offer nutritional management recommendations for paediatric patients with an HOI. Methods PubMed and Embase were searched for relevant English or French language papers up to 31 June 2022. The emphasis was placed on studies involving paediatric ileostomy patients, but insights were obtained from adult literature and other intestinal failure pathologies when these were lacking. Results We identified 16 papers that addressed nutritional issues in paediatric ileostomy patients. Currently, no evidence supports a safe paediatric HOI threshold exceeding 20 mL/kg/day on two consecutive days. Paediatric HOI patients were at risk of dehydration, electrolyte disturbances, micronutrient deficiencies and growth failure. The primary dietary choice for neonates is bolus feeding with breastmilk. In older children, an enteral fluid restriction should be installed favouring isotonic or slightly hypotonic glucose‐electrolyte solutions. A diet that is high in calories, complex carbohydrates and proteins, low in insoluble fibre and simple carbohydrates, and moderate in fat is recommended. Conclusion Adequate nutritional management is crucial to prevent complications in children with an HOI. Further research is needed to establish more evidence‐based guidelines.
ISSN:	0803-5253 1651-2227