Flora K Szabo1, Lin Fei2, Ligia Alfaro Cruz3, Maisam Abu-El-Haija4. 1. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 2. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 3. Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 4. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address: maisam.haija@cchmc.org.
Abstract
OBJECTIVES: To determine whether recommendations for treatment of acute pancreatitis (AP) in adults impact the outcomes of pediatric AP. STUDY DESIGN: Adult guidelines regarding early management of AP were implemented through an admission order set at Cincinnati Children's Hospital Medical Center at the beginning of the year 2014. Recommendations included administering high rates of intravenous fluid (IVF) within 24 hours of admission and enteral nutrition within 48 hours of admission. A retrospective chart review of AP admissions before and after the implementation of the recommendations was undertaken. Outcomes studied were: hospital length of stay, intensive care unit transfer rates, development of severe AP, pulmonary complications, and readmission rates post discharge from the hospital. RESULTS: The study included 201 patients. Children who received feeds within the first 48 hours and received greater than maintenance IVF within 24 hours had a shorter length of stay, less intensive care unit admissions and severe AP rates compared with the patients who remained nil per os during the first 48 hours and received lower rates of IVF. CONCLUSION: Our data support that early enteral nutrition and early aggressive IVF improve outcomes of pediatric AP.
OBJECTIVES: To determine whether recommendations for treatment of acute pancreatitis (AP) in adults impact the outcomes of pediatric AP. STUDY DESIGN: Adult guidelines regarding early management of AP were implemented through an admission order set at Cincinnati Children's Hospital Medical Center at the beginning of the year 2014. Recommendations included administering high rates of intravenous fluid (IVF) within 24 hours of admission and enteral nutrition within 48 hours of admission. A retrospective chart review of AP admissions before and after the implementation of the recommendations was undertaken. Outcomes studied were: hospital length of stay, intensive care unit transfer rates, development of severe AP, pulmonary complications, and readmission rates post discharge from the hospital. RESULTS: The study included 201 patients. Children who received feeds within the first 48 hours and received greater than maintenance IVF within 24 hours had a shorter length of stay, less intensive care unit admissions and severe AP rates compared with the patients who remained nil per os during the first 48 hours and received lower rates of IVF. CONCLUSION: Our data support that early enteral nutrition and early aggressive IVF improve outcomes of pediatric AP.
Authors: Maisam Abu-El-Haija; Aliye Uc; Steven L Werlin; Alvin Jay Freeman; Miglena Georgieva; Danijela Jojkić-Pavkov; Daina Kalnins; Brigitte Kochavi; Bart G P Koot; Stephanie Van Biervliet; Jaroslaw Walkowiak; Michael Wilschanski; Veronique D Morinville Journal: J Pediatr Gastroenterol Nutr Date: 2018-07 Impact factor: 2.839
Authors: Maisam Abu-El-Haija; Soma Kumar; Jose Antonio Quiros; Keshawadhana Balakrishnan; Bradley Barth; Samuel Bitton; John F Eisses; Elsie Jazmin Foglio; Victor Fox; Denease Francis; Alvin Jay Freeman; Tanja Gonska; Amit S Grover; Sohail Z Husain; Rakesh Kumar; Sameer Lapsia; Tom Lin; Quin Y Liu; Asim Maqbool; Zachary M Sellers; Flora Szabo; Aliye Uc; Steven L Werlin; Veronique D Morinville Journal: J Pediatr Gastroenterol Nutr Date: 2018-01 Impact factor: 2.839
Authors: Maisam Abu-El-Haija; Anna S Gukovskaya; Dana K Andersen; Timothy B Gardner; Peter Hegyi; Stephen J Pandol; Georgios I Papachristou; Ashok K Saluja; Vikesh K Singh; Aliye Uc; Bechien U Wu Journal: Pancreas Date: 2018 Nov/Dec Impact factor: 3.327