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ASPEN 2019 Nutrition Science & Practice Conference


NPPC-2019 - Nutrition for the Practicing Pediatric Clinician: Nutrition Support Challenges in the Intestinal Failure Patient


Mar 23, 2019 12:00pm ‐ Mar 23, 2019 4:00pm


Credits: None available.

Standard: $79.00
Members: $49.00

Description

Patients with intestinal failure (IF) represent a challenging group. Their nutrition support and management need to be tailored based on the bowel segment resected, the amount of resection as well as underlying disease etiology. There is also ongoing debate for intestinal lengthening procedures and their timing for maximizing nutrient absorption. Enteral or parenteral nutrition support and their respective percentages to promote parenteral nutrition autonomy as well as the optimal surgical procedures to enable enteral nutrition delivery like gastrostomy / gastro-jejonostomy or jejunostomy tube and bolus vs continuous feeds present significant challenges. Challenges also remain in treating small bowel bacterial overgrowth as well as instituting gut motility modulators in such patients. Recent data also presents new evidence of alteration in nutrient absorption and assimilation based on influences by the gut microbiota, bile acids and systemic effects modulated by downstream targets with key gut luminal receptor activation. This preconference will present current evidence supporting clinical practices and highlight potential pitfalls in the management of this patient population.

Learning Objectives:

  • Identify key pathophysiological changes affecting nutrition status based on the site and amount of bowel segment resected
  • Critically examine the current indications, timing, and nutritional consequences of bowel lengthening and other surgical procedures for patients with intestinal failure
  • Discuss implications of variances in enteral feeding like continuous vs bolus feeding, type of formula, and route of nutrition delivery
  • Describe various medical therapies and the role of nutritional supplements (probiotics, pre-biotics, fiber) offered to improve enteral feeding tolerance with a goal of enteral autonomy
  • Summarize current basic and translational research alluding to the role of gut microbiota, bile acids and key gut signaling affecting nutrition outcomes in patients with intestinal failure

Moderator(s):

  • Charlene Compher, PhD, RD, CNSC, LDN, FASPEN, Professor of Nutrition Science; Shearer Chair in Health Community Programs; Faculty Director, Nutrition Programs, University of Pennsylvania School of Nursing, Philadelphia, PA
  • Timothy Sentongo, MD, Associate Professor of Pediatrics; Director, Pediatric Nutrition Support; Director, Pediatric Gastrointestinal Endoscopy, Section of Pediatric Gastroenterology, Hepatology & Nutrition, University of Chicago Medicine, Chicago, IL

Speaker(s):

  • Jeffrey Rudolph, MD, Director, Intestinal Care and Rehabilitation Center, Division of Pediatric Gastroenterology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA
  • Samuel Kocoshis, MD, Medical Director, Intestinal Care Center; Medical Director, Small Bowel Transplantation Program, Cincinnati Children’s Hospital, Cincinnati, OH
  • Gail Cresci, PhD, RD, LD, CNSC, Department of Pediatric Gastroenterology; Director of Nutrition Research, Center for Human Nutrition, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH
  • Valeria C. Cohran, MD, Medical Director, Intestinal Rehabilitation and Transplantation; Attending Physician, Gastroenterology, Ann & Robert H. Lurie Children’s Hospital of Chicago; Associate Professor of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
  • Beth Lyman, MSN, RN, CNSC, FASPEN, Nutritional Support Nurse Consultant LLC, Children's Mercy Kansas City, Kansas City, MO
  • Rebecca Johnson, PhD, Child Psychologist, Children's Mercy Kansas City; Associate Professor of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO
  • Dave Mercer, MD, PhD, FRCS, Professor of Surgery, University of Nebraska Medical Center, Omaha, NE
  • Ajay Jain, MD, Associate Professor; Chairman, Nutritional Advisory Committee; Medical Director, Pediatric Liver Transplantation, Saint Louis University, St. Louis, MO

Credits

Credits: None available.

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