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Síndrome do Intestino Curto em Crianças: análise crítica dos métodos terapêuticos
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Abstract(s)
A Síndrome do Intestino Curto (SIC) em crianças é uma condição complexa
caracterizada pela perda física e/ou funcional de parte do intestino delgado e/ou grosso,
comprometendo a absorção eficaz de nutrientes essenciais como gorduras, hidratos de
carbono, vitaminas e minerais. Na infância, esta síndrome pode resultar de
malformações congénitas ou ressecção cirúrgica extensa.
Face ao comprometimento da capacidade de absorção e à necessidade de garantir um
aporte nutricional adequado para o crescimento e desenvolvimento infantil, a nutrição
parentérica surge como uma intervenção de primeira linha. Esta abordagem proporciona
suporte nutricional enquanto se procura promover a adaptação do intestino delgado
remanescente. No entanto, o uso prolongado de nutrição parentérica está associado a
diversas complicações, sublinhando a importância de uma estratégia médico-cirúrgica
personalizada.
O tratamento da SIC em crianças abrange várias opções terapêuticas. Para além da
nutrição parentérica, incluem-se as terapias hormonais, como a utilização de análogos
do peptídeo-2 semelhante ao glucagon específico do intestino (GLUT-2), e as cirurgias
de alongamento intestinal. O transplante intestinal é reservado para casos graves,
particularmente naqueles onde há uma a impossibilidade de nutrição adequada pelas
vias enteral e/ou parenteral ou nos casos associados a doença hepática progressiva e
complicações relacionadas com cateteres venosos centrais.
O objetivo principal do tratamento é promover a adaptação intestinal, melhorar o perfil
nutricional e minimizar complicações. Uma abordagem personalizada é essencial no
tratamento da SIC, tendo em consideração as causas específicas da Insuficiência
Intestinal em cada criança. Esta estratégia multifacetada visa não apenas a gestão dos
sintomas, mas também a melhoria da qualidade de vida e o desenvolvimento adequado
destes pacientes pediátricos.
Short Bowel Syndrome (SBS) in children is a complex condition characterized by the physical or functional loss of part of the small and/or large intestine, compromising the effective absorption of essential nutrients such as fats, carbohydrates, vitamins, and minerals. In childhood, this syndrome can result from congenital malformations or extensive surgical resection. Given the impaired absorption capacity and the need to ensure adequate nutritional intake for the child’s growth and development, parenteral nutrition emerges as a firstline intervention. This approach provides nutritional support while promoting adaptation of the remaining intestine. However, the prolonged use of parenteral nutrition is associated with various complications, highlighting the importance of a personalized medical-surgical strategy. The treatment of SBS in children includes several therapeutic options. In addition to parenteral nutrition, hormonal therapies, such as the use of glucagon-like peptide-2 (GLP-2) analogs, and intestinal lengthening surgeries are included. Intestinal transplantation is reserved for severe cases, particularly those associated with progressive liver disease and complications related to central venous catheters. The main goal of treatment is to promote intestinal adaptation, improve the nutritional profile, and minimize complications. A personalized approach is essential in the treatment of SBS, taking into account the specific causes of Intestinal Failure in each child. This multifaceted strategy aims not only to manage symptoms but also to improve the quality of life and ensure proper development for these pediatric patients.
Short Bowel Syndrome (SBS) in children is a complex condition characterized by the physical or functional loss of part of the small and/or large intestine, compromising the effective absorption of essential nutrients such as fats, carbohydrates, vitamins, and minerals. In childhood, this syndrome can result from congenital malformations or extensive surgical resection. Given the impaired absorption capacity and the need to ensure adequate nutritional intake for the child’s growth and development, parenteral nutrition emerges as a firstline intervention. This approach provides nutritional support while promoting adaptation of the remaining intestine. However, the prolonged use of parenteral nutrition is associated with various complications, highlighting the importance of a personalized medical-surgical strategy. The treatment of SBS in children includes several therapeutic options. In addition to parenteral nutrition, hormonal therapies, such as the use of glucagon-like peptide-2 (GLP-2) analogs, and intestinal lengthening surgeries are included. Intestinal transplantation is reserved for severe cases, particularly those associated with progressive liver disease and complications related to central venous catheters. The main goal of treatment is to promote intestinal adaptation, improve the nutritional profile, and minimize complications. A personalized approach is essential in the treatment of SBS, taking into account the specific causes of Intestinal Failure in each child. This multifaceted strategy aims not only to manage symptoms but also to improve the quality of life and ensure proper development for these pediatric patients.
Description
Keywords
Adaptação
Intestinal Nutrição Parentérica Síndrome do Intestino Curto Terapia Hormonal Transplante Intestinal