Correlation Between Parenteral Nutrition and Citrulline Levels of Pediatric Patients Who Underwent Surgery for Intestinal Disorders in Indonesia.

Background/aims: Parenteral nutrition is often administered after a small bowel resection, but it can increase the risk of complications such as sepsis and organ disorders. Citrulline has been identified as a potential biomarker that correlates with intestinal adaptation, affects the tolerance to enteral nutrition, and predicts the duration of parenteral nutrition. This study examined the correlation between parenteral nutrition and the plasma citrulline levels of pediatric patients who underwent surgery for small bowel disorders.

Methods: This cross-sectional study compared the citrulline levels before and after administering parenteral nutrition to infants and children with small bowel disorders who required surgery at the Pediatric and Surgery Inpatient Ward of Dr. Soetomo General Hospital, Surabaya, Indonesia, between April and July 2023.

Results: The mean citrulline level before parenteral nutrition administration was 1.44 nmol/mL (±0.48 nmol/mL) and increased to 1.89 nmol/mL (±1.73 nmol/mL) after (no significant difference; p=0.231). No significant changes in the citrulline levels in any of the samples, intestinal resection, or the presence of the ileocecal junction were observed before and after administering parenteral nutrition. Positive correlations were observed between the citrulline level and hospital length of stay (moderate strength; r=0.451; p=0.024) and between the citrulline level and parenteral nutrition duration (moderate strength; r=0.439; p=0.028).

Conclusions: The citrulline levels before and after parenteral nutrition administration were similar.