Τίτλος:
European Society for Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children with Neurological Impairment
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objectives: Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment. Methods: Thirty-one clinical questions addressing the diagnosis, treatment, and prognosis of common gastrointestinal and nutritional problems in neurological impaired children were formulated. Questions aimed to assess the nutritional management including nutritional status, identifying undernutrition, monitoring nutritional status, and defining nutritional requirements; to classify gastrointestinal issues including oropharyngeal dysfunctions, motor and sensory function, gastroesophageal reflux disease, and constipation; to evaluate the indications for nutritional rehabilitation including enteral feeding and percutaneous gastrostomy/jejunostomy; to define indications for surgical interventions (eg, Nissen Fundoplication, esophagogastric disconnection); and finally to consider ethical issues related to digestive and nutritional problems in the severely neurologically impaired children. A systematic literature search was performed from 1980 to October 2015 using MEDLINE. The approach of the Grading of Recommendations Assessment, Development, and Evaluation was applied to evaluate the outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation using the nominal voting technique. Expert opinion was applied to support the recommendations where no randomized controlled trials were available. Copyright © 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
Συγγραφείς:
Romano, C.
Van Wynckel, M.
Hulst, J.
Broekaert, I.
Bronsky, J.
Dall'Oglio, L.
Mis, N.F.
Hojsak, I.
Orel, R.
Papadopoulou, A.
Schaeppi, M.
Thapar, N.
Wilschanski, M.
Sullivan, P.
Gottrand, F.
Περιοδικό:
Journal of Pediatric Gastroenterology and Nutrition,
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
iron; protein; trace element, anthropometry; Article; body composition; bone disease; bone mineralization; caloric intake; caregiver; child health care; constipation; dysphagia; enteric feeding; esophagus surgery; feeding behavior; feeding difficulty; fluid intake; gastroesophageal reflux; gastrointestinal disease; growth curve; human; iron intake; jejunostomy; lifestyle modification; malnutrition; medical ethics; motor dysfunction; neurologic disease; nutritional assessment; nutritional disorder; nutritional requirement; nutritional status; nutritional support; patient monitoring; pediatric rehabilitation; percutaneous endoscopic gastrostomy; practice guideline; priority journal; prognosis; protein intake; quality of life; randomized controlled trial (topic); speech and language rehabilitation; stomach fundoplication; stomach surgery; systematic review (topic); child; complication; consensus development; diet therapy; gastrointestinal disease; morphometry; muscle training; neurologic disease; nutrition policy; nutritional disorder; practice guideline; procedures, Body Composition; Body Weights and Measures; Child; Diet Therapy; Enteral Nutrition; Gastrointestinal Diseases; Humans; Myofunctional Therapy; Nervous System Diseases; Nutrition Assessment; Nutrition Disorders; Nutrition Policy; Nutritional Requirements; Prognosis
DOI:
10.1097/MPG.0000000000001646
