ENTERALNA PREHRANA U KRONIČNOM ZATAJENJU CRIJEVA U DJECE

Iva Hojsak, Sanja Kolaček

Opće je mišljenje da je enteralna prehrana »Condicio sine qua non« u terapiji kroničnog zatajenja tankog crijeva. Međutim, optimalan režim njezine primjene još nije točno utvrđen te kliničari rabe različite algoritme. Slijedom navedenoga, cilj je ovoga preglednog članka ujediniti trenutačno dostupne dokaze o načinu primjene enteralne prehrane u djece sa zatajenjem crijeva te iznijeti preporuke koje se temelje na tim dokazima. Prema dostupnim podacima enteralno hranjenje treba početi što ranije, kontinuiranom primjenom (sonda/stoma), postupnim povisivanjem količine i koncentracije, uz praćenje kliničkog stanja djeteta. Ako je dostupno, treba davati majčino mlijeko, inače se prednost daje elementarnom pripravku (formuli). Važno je cijelo vrijeme stimulirati peroralni unos. Adekvatnim zbrinjavanjem bolesnika mogu se znatno smanjiti posljedice kroničnog zatajenja crijeva i parenteralne prehrane, ponajprije zatajenje jetre, a enteralna prehrana u tom procesu ima neprijeporno važnu ulogu.

Although the importance of enteral nutrition in the treatment of intestinal failure is well recognized, the optimal regime is still a matter of debate and clinicians often use different treatment algorithms. Therefore, the aim of this review was to present an overview of currently available evidence on the role of enteral nutrition in children with intestinal failure and to give evidence-based recommendations for clinical practice. According to the published data, enteral feeding should be initiated early after surgical resection with continuous feeding mode, gradually increasing the amount and concentration of formula based on child’s clinical condition. If available, breast milk should be recommended; otherwise the priority is given to an elemental formula. It is very important to stimulate the oral intake. Optimal care for patients with intestinal failure can significantly reduce complications, primarily severe infections and liver disease, and the role of enteral nutrition in this process is of extreme importance.