Thanks to the technical progresses during the last decade and to the active participation of parents, parenteral nutrition may be undertaken at home in patients with chronic digestive or extra-digestive diseases with serious undernutrition. This technique being highly sophisticated and demanding, we have undertaken a study of the quality of life of 44 children submitted to home parenteral nutrition and followed by the four registered French centres of pediatric nutrition. This study shows that home parenteral nutrition improves the quality of life of both children and parents as compared with the preceding period in the hospital. However, because of its constraints, it requires a careful evaluation of the parents' capacity to cope with, before to be undertaken.
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Pediatr Nephrol
January 2025
Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong, China.
This case report presents a newborn with pyruvate dehydrogenase complex deficiency who developed significant lactic acidosis and acute kidney injury after birth. Peritoneal dialysis with glucose-based peritoneal dialysis fluid was initially started, but the patient had worsening hyperglycemia and lactic acidosis, likely related to excess glucose reabsorption with shunting to lactate due to the underlying metabolic disorder. As amino acid-based dialysis solution was not available in our formulary, a dialysis fluid was manually created with Vaminolact, which was commonly used in neonatal parenteral nutrition.
View Article and Find Full Text PDFCrit Care
January 2025
Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, 3000, Leuven, Belgium.
Background: As compared to withholding parenteral nutrition (PN) until one week after intensive care unit (ICU) admission, Early PN prolonged ICU dependency in the EPaNIC randomized controlled trial (RCT). The Refeeding RCT showed improved outcome by temporary macronutrient restriction in ICU patients developing refeeding hypophosphatemia, defined as a phosphate decrease of > 0.16 mmol/L to levels < 0.
View Article and Find Full Text PDFPediatr Nephrol
January 2025
Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, 1-6-7 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 6500047, Japan.
Wernicke's encephalopathy (WE) is a severe neurological condition caused by the deficiency of thiamine, which is a vitamin B1 molecule. Herein, we present the case of a 3-year-old girl with steroid-resistant nephrotic syndrome (SRNS) who did not achieve remission despite steroid pulse therapy (MPT) and rituximab. She had frequent vomiting and decreased oral intake on the 61st day.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Nishtar Medical University, Multan, PAK.
Progressive familial intrahepatic cholestasis type 2 (PFIC2) is a rare genetic disorder characterized by severe intrahepatic cholestasis, which often manifests in infancy with progressive liver dysfunction. We present the case of a 3-month-old infant with a one-month history of jaundice, vomiting, and bloody stools, presenting a unique set of diagnostic challenges. Initial clinical and laboratory findings indicated significant liver dysfunction, prompting further imaging and genetic analysis.
View Article and Find Full Text PDFJ Multidiscip Healthc
January 2025
Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, Madinah, Kingdom of Saudi Arabia.
Background: Enteral Nutrition (EN) is the preferred method for providing nutritional support in intensive care units (ICUs) compared to parenteral nutrition (PN) due to its physiological advantages, safety profile, and cost-effectiveness compared to parenteral nutrition (PN). However, evidence suggests that EN might be associated with some complications. In this study, we aimed to identify the most common EN complications, as reported by healthcare professionals (HCPs) working in adult and paediatric ICUs (PICUs) in Saudi Arabia.
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