[Parenteral nutrition in pediatric patients: indications and complications in third level]. / Nutrición parenteral en pacientes pediátricos: indicación y complicaciones en tercer nivel.

BACKGROUND: Parenteral nutrition (PN) is a mixture that covers the nutritional needs when enteral nutrition is not an option; however, PN is not free of complications. The aim of our study was to determine the indication and frequency of NP complications in pediatric patients treated at a tertiary center. METHODS: Children receiving PN at the Hospital de Pediatría del Centro Médico Nacional Siglo XXI were included. Demographic and anthropometric characteristics were recorded, as well as the reason of indicating PN, the time of administration, and the complications associated to this type of nutrition. RESULTS: Sixty-nine pediatric patients with PN were included: 33 neonates, 18 infants (between one and 11 months of age), nine preschoolers (from 1 to 5 years of age), and nine children over five years of age. Instructions for initiating the PN were given for the treatment of 71 % of the patients with diseases of the digestive tract who were treated surgically. Complications of PN occurred in 87 % of the children and 76.7 % had more than one complication. Metabolic complications occurred in 98 % of the children while mechanical and infectious complications only in 1 %, respectively. CONCLUSIONS: Parenteral nutrition was indicated more frequently in pediatric patients with digestive diseases treated surgically. Metabolic complications were the main concern in pediatric patients with PN.

Introducción: la nutrición parenteral (NP) es una mezcla que cubre las necesidades nutricionales cuando no es posible lograr esta tarea por la vía enteral en el paciente; sin embargo, no está exenta de complicaciones. El objetivo del estudio fue conocer la indicación y la frecuencia de complicaciones de la NP en pacientes pediátricos atendidos en un centro de tercer nivel. Métodos: se incluyeron niños que recibieron NP en el Hospital de Pediatría del Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social. Se registraron las características demográficas, antropométricas, la causa de la indicación de la NP, su tiempo de administración y las complicaciones asociadas a este tipo de nutrición. Resultados: se incluyeron 69 pacientes pediátricos: 33 recién nacidos (RN) y 18 lactantes entre uno y 11 meses de edad; nueve preescolares entre uno y cinco años, y nueve niños mayores de cinco años. Las enfermedades del tracto digestivo tratadas quirúrgicamente constituyeron el 71 % de las indicaciones para el inicio de NP. Se presentaron complicaciones en el 87 % de los pacientes y 76.7% tuvieron más de una complicación. Las complicaciones metabólicas representaron 98 %, las mecánicas 1 % y las infecciosas 1 %. Conclusión: la NP en este centro de tercer nivel se indicó principalmente a pacientes sometidos a cirugía del tracto digestivo.

[Survival and morbidity of infants with necrotizing enterocolitis treated with surgery]. / Cirugía en enterocolitis necrotizante en niños. Supervivencia y morbilidad.

OBJECTIVES: to determine the survival rate and type of morbidity during the first year of life of infants with necrotizing enterocolitis (NED) who underwent to surgical treatment. METHODS: a comparative and descriptive study was performed. Thirty two children with NEC (19 deaths and 13 survivals) who underwent to surgery during neonatal period were studied. Perinatal conditions, surgical procedures and findings, morbidity and survival rate during the first year of life were registered. RESULTS: all patients underwent to laparotomy, except three patients who died and were managed with peritoneal drainage only. During the first year of life, cholestasis and intestinal obstruction were the main causes of morbidity in survivals and deaths. Survival rate during neonatal period was 78 %, and 40.6% in the first year of life. CONCLUSIONS: morbidities during the first year of life were related to surgery. In this series, there was a high survival rate in neonatal period, which diminished in the first year of life.