Neonatal Onset Intestinal Failure: An Italian Multicenter Study

Objective To describe the natural course of intestinal failure with onset in the neonatal period to provide data regarding th occurrence and to provide a population-based survey regarding the spectrum of underlying diseases. Study design We performed a retrospective chart review including infants admitted to the neonatal intensive care unit c 7 Italian tertiary care centers. Intestinal failure was defined as a primary intestinal disease that induces the need of total parenteral nutrition (PN) for more than 4 weeks or the need of partial PN for more than 3 months. Results The total number of five births during the study time within the enrolled institutions was 30 353, and the number of newborns admitted to the neonatal intensive care unit was 5088. Twenty-six patients satisfied the definition of intestinal., failure:, thus the occurrence rate of intestinal failure was 0.1% among live-birth newborns and 0.5% among infants at high risk The main underlying diseases leading to intestinal failure in neonatal age were congenital intestinal defects (42.3%), necre tizing enterocolitis (30.8%), severe intestinal motility disorder (11.5%), intestinal obstruction (7.7%) structural enterocyt defects (3.8%), and meconium peritonitis (3.8%) After a follow-up of 36 months, 84.6% of patients achieved intestinal, competence, I patient was still receiving home PN. 1 patient underwent transplantation. and 2 patients died. Cholestatic live disease was diagnosed in 54% of observed children. Conclusion An understanding of the incidence, causes, and natural history of intestinal failure would be helpful appropriately allocate resources and to plan clinical trials. (J Pediatr 2008353:674-6)