Italian SIGENP (Italian Society of gastroenterology, hepatology and pediatric nutrition) registry of pediatric home artificial nutrition: First report

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-09-11 DOI:10.1016/j.clnesp.2025.07.1129

Antonella Lezo , Antonella Diamanti , Leila Cravero , Teresa Capriati , Laura Lacitignola , Paolo Gandullia , Lorenzo Norsa , Elvira Verduci , Silvia Salvatore , Giovanna Verlato , Barbara Parma , Giuseppe Pasolini , Claudio Romano , Maria Immacolata Spagnuolo

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引用次数: 0

Abstract

Background

Home Artificial Nutrition (HAN), including Home Enteral Nutrition (HEN) and Home Parenteral Nutrition (HPN), is essential for managing pediatric patients with complex nutritional needs. This article presents the first report from the Italian Pediatric HAN registry, promoted and endorsed by the Italian Society for Pediatric Gastroenterology, Hepatology, and Nutrition (SIGENP) in order to document HAN practices and clinical outcomes.

Aims

The registry aims to analyze data from the Italian network of pediatric HAN to provide insights into its epidemiology, efficacy and safety.

Methods

Established in 2020, the registry is an online platform accessible via the SIGENP website (www.nad-sigenp.org/site/home) for recording data on pediatric patients aged 0–19 years who currently or previously required HAN. Registered SIGENP network centers enter data on patient demographics, nutritional support details, clinical outcomes and complications.

Results

As of December 31, 2022, the registry included 3525 home artificial nutrition programs (2402 HEN, 917 oral nutritional supplements [ONS]and 206 HPN) provided by 13 centers across 9 regions. The prevalence of pediatric HAN in Italy reached 365 programs per million inhabitants aged 0–19 years (249 HEN, 57 ONS, and 21 HPN), showing a clear increase compared to previous national surveys conducted by the Italian Society of Artificial Nutrition and Metabolism (SINPE) [12]. Mean age at initiation was 1.8 years for HEN and 0.9 years for HPN. Median duration of HEN was 1.4 years, predominantly prescribed for neurological patients, showing significant correlation between early HEN initiation and improved nutritional outcomes. Major complication rate for HEN was 2.3 % (n = 55; e.g. gastrocolic fistula, aspiration pneumonia, significant bleeding). Among HPN patients, intestinal failure-associated liver disease (IFALD) was detected in 8.3 % based on gamma-glutamyl transferase (GGT) ≥2 × normal, 3.9 % based on bilirubin >1 mg/dL, and 11.6 % based on alanine aminotransferase (ALT) ≥2 × normal each persisting for more than three months. Hepatic steatosis and biliary sludge occurred in 23.3 % and 16.0 % of patients, respectively. Complications rate and prevalence align with international trends, confirming the importance and safety of home care in children with chronic diseases.

Conclusions

The registry provides a comprehensive overview of pediatric HAN practices in Italy, highlighting a significantly growing need for specialized nutritional care. The predominance of HEN, especially among neurological patients, underscores its critical role in long-term nutritional management. The observed correlation between early initiation of HEN and improved nutritional outcomes reinforces the importance of timely nutritional interventions. HPN remains less common, as it is mainly indicated for patients with primary intestinal failure. The registry's data provide valuable insights into epidemiological trends and clinical practices, which contribute to future policy development for pediatric HAN.

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意大利SIGENP（意大利胃肠病学、肝病学和儿科营养学会）儿科家庭人工营养登记：第一份报告。

背景：家庭人工营养（HAN），包括家庭肠内营养（HEN）和家庭肠外营养（HPN），对于管理具有复杂营养需求的儿科患者至关重要。这篇文章提出了意大利儿科HAN注册的第一份报告，由意大利儿科胃肠病学、肝病学和营养学会（SIGENP）推广和认可，以记录HAN实践和临床结果。目的：该注册表旨在分析来自意大利儿科HAN网络的数据，以深入了解其流行病学、有效性和安全性。方法：该注册中心建立于2020年，是一个可通过SIGENP网站（www.nad-sigenp.org/site/home）访问的在线平台，用于记录目前或以前接受过HAN治疗的0-19岁儿科患者的数据。注册的SIGENP网络中心输入患者人口统计数据、营养支持细节、临床结果和并发症。结果：截至2022年12月31日，该登记处包括9个地区13个中心提供的3525个家庭人工营养项目（2402个HEN， 917个口服营养补充剂[ONS]和206个HPN）。意大利0-19岁儿童HAN的患病率达到每百万居民365个项目（249个HEN， 57个ONS和21个HPN），与意大利人工营养与代谢学会（SINPE） bbb之前进行的全国调查相比，显示出明显的增加。HEN的平均起始年龄为1.8岁，HPN的平均起始年龄为0.9岁。HEN的中位持续时间为1.4年，主要用于神经系统患者，显示早期HEN启动与改善营养结果之间存在显著相关性。HEN的主要并发症发生率为2.3% （n=55，如胃结肠瘘、吸入性肺炎、大出血）。在HPN患者中，8.3%的患者以γ -谷氨酰转移酶(GGT)≥2倍正常为标准检测出肠衰竭相关肝病（IFALD）， 3.9%的患者以胆红素≥1 mg/dL为标准，11.6%的患者以丙氨酸转氨酶(ALT)≥2倍正常为标准，均持续3个月以上。肝脂肪变性和胆道淤积发生率分别为23.3%和16.0%。并发症发生率和流行率与国际趋势一致，证实了慢性病儿童家庭护理的重要性和安全性。结论：该注册表提供了意大利儿科HAN实践的全面概述，突出了对专业营养护理的显著增长需求。HEN的优势，特别是在神经系统患者中，强调了其在长期营养管理中的关键作用。观察到的HEN早期启动与改善营养结果之间的相关性加强了及时营养干预的重要性。HPN仍然不太常见，因为它主要适用于原发性肠衰竭患者。该登记处的数据为流行病学趋势和临床实践提供了有价值的见解，有助于未来儿科HAN的政策制定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.