New and Potential Treatments To Lengthen Life in Pediatric Short Bowel Syndrome
Rachael E. Prendergast
Short bowel syndrome (SBS) is a syndrome in which a significant amount of intestine is lost due to functional or congenital anomalies, resulting in maldigestion, malabsorption, and malnutrition. Children with SBS rely on parenteral nutri tion (PN) for energy and growth. However, this life-sustaining treatment is associated with liver failure and intestinal atrophy, among other complications that can lead to morbidity and mortality. Thus, the goal of SBS therapy is to achieve enteral autonomy. The purpose of this article is to evaluate therapies aimed at protecting the bowel, promoting intestinal adaption, and increasing intestinal absorptive capabilities, with the goal of weaning PN support and achieving enteral autonomy in pediatric SBS. These therapies include bowel-lengthening procedures, bowel tissue engineering, and new hormonal treatments. Promising hormonal treatments include teduglutide, ghrelin, growth hormone, and glutamine. Additionally, new parenteral lipids formulations, Smoflipid® and Omegaven®, can result in improved long-term outcomes in children with SBS when compared to the current standard soy lipid. Nurses should consider these lipid options and therapies to help wean PN support and achieve enteral autonomy in pediatric SBS.