What are Some of the Complications of Short Bowel Syndrome?
Discussion Necrotizing enterocolitis (NEC) is one of the most common gastrointestinal emergencies in neonates. Mortality rates are from 0-45% depending on infant weight and gestation with more premature and smaller infants having greater mortality. NEC usually occurs in premature infants but it also occurs in term infants. The etiology is unknown but is probably multifactorial with ischemia and/or reperfusion playing some role. There are ‘outbreaks’ of NEC but no causative organism has been identified. Regardless of the originating cause, inflammation of the intestine and release of inflammatory mediators causes various degrees of damage to the intestine. Patients who had a history of surgically treated NEC have an increased risk of neurodevelopmental disabilities such as the patient above. Treatment includes stopping gastric feeding, antibiotics, possible surgery and other supportive measures such as treatment for hypotension and respiratory failure. Presenting signs of NEC can be subtle but can include: Feeding intolerance Delayed gastric emptying Apnea Abdominal distention and/or tenderness Bleeding diathesis Blood in the stool – obvious or occult Decreased bowel sounds – i.e. ileus Erythema of the abdominal wall Lethargy Shock and/or poor perfusion Abnormal laboratory testing can include metabolic acidosis, hyponatremia, leukocytosis or leukopenia or thrombocytopenia. Intestinal failure is a broad term that includes short bowel syndrome (SBS &nda...
Conclusions Implantation of an LVAD is associated with significant, nonlinear improvement in short-term memory and global cognitive function, with the most significant improvements occurring in the first 3 months after implantation. Clinicians should anticipate improvements in cognitive function after LVAD implantation and modify postimplantation education to maximize effectiveness of LVAD self-care.
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