Survival of infants with neonatal SBS now approaches 90%. However, long term PN is required in many. Predicting the duration of dependence on PN would be an asset for those caring for these patients. We reviewed the charts of every infant in our center with neonatal SBS since 1985 who required PN for> 3 mos. Of 41 records, 40 were complete. We assessed the impact of several variables on length of time the patient required PN - gestational age, birth weight and length, cm of small bowel remaining after initial surgery, presence of ileocecal valve, sepsis events per month on PN, cholestasis (conjugated bilirubin > 2.0 mg/dL), and% of calories taken enterally at 3 and 6 months corrected age. 25 patients adapted to enteral feeding, discontinuing PN in 3-36 mos (PN-Off). 6 patients on PN >36 mos (range 37-126) appear permanently PN dependent (PN-Dep). Final outcome is unclear in 6 patients on PN < 36 mos (range 4-29). 3 patients died of liver failure while on PN (9, 15, 19 mos).
The 25 PN-Off patients differed significantly from the 6 PN-Dep patients in cm of bowel remaining (94.4 ± 12.2 vs 36.5 ± 6.8 cm; p <.01)(mean ± SEM), percent of feedings taken enterally at 3 months (41.8± 6.7 vs 9.9 ± 4.0; p <.01), percent of feedings taken enterally at 6 months (55.4 ± 6.1 vs 14.3 ± 5.3; p <.01), and presence of ileocecal valve (64% vs 33%; p <.05). Diagnoses causing SBS, incidence of cholestasis, sepsis events per month of PN, gestational age, and birth weight and length were similar in the two groups.
