Trial reportThe Journal of pediatrics2018
Postoperative Enteral Nutrition Guidelines Reduce the Risk of Intestinal Failure-Associated Liver Disease in Surgical Infants.
Trial report in The Journal of pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Nutritional management of neonates who undergo major surgery for gastrointestinal disorders: a joint position paper of the Italian Society of Neonatology (SIN), the Italian Society of Pediatric Surgery (SICP), and the Italian Society of Pediatric Nutrition (SINUPE).Italian journal of pediatrics · 2026Guideline
- Role of Nutrition in Prevention of Neonatal Spontaneous Intestinal Perforation and Its Complications: A Systematic Review.Nutrients · 2020Pooled it
- Article
- Current state of neonatal intestinal rehabilitation care in North America: A descriptive survey-based study.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026Article
- The anatomical type of atresia drives the risk of home parenteral nutrition of infants with congenital jejunoileal atresia.European journal of pediatrics · 2026Article
- Enteral nutrition in neonates: current evidence from clinical trials and evolving strategies.Seminars in perinatology · 2026Review
- Review
- Association between postoperative feeding patterns and gastrointestinal function reconstruction after congenital intestinal atresia in neonates.World journal of gastrointestinal surgery · 2025Article
- Pathogenesis and Management of Intestinal Failure-Associated Liver Disease.Seminars in liver disease · 2025Review
- Optimizing nutritional strategies in term NEC and perforation infants after intestinal operation: a retrospective study.Scientific reports · 2025Article
- Current Insights Regarding Intestinal Failure-Associated Liver Disease (IFALD): A Narrative Review.Nutrients · 2023Review
- Disruption of Enterohepatic Circulation of Bile Acids Ameliorates Small Bowel Resection Associated Hepatic Injury.Journal of pediatric surgery · 2023Article
- Article
- [Prevention and treatment strategies for intestinal failure-associated liver disease].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Article
- Review
- Effect of Home Enteral Nutrition on Nutritional Status, Body Composition and Quality of Life in Patients With Malnourished Intestinal Failure.Frontiers in nutrition · 2021Article
- New Insights Into Intestinal Failure-Associated Liver Disease in Children.Hepatology (Baltimore, Md.) · 2020Review
- Actively implementing enteral nutrition to reduce parenteral nutrition-associated liver disease.Hepatobiliary surgery and nutrition · 2018Article
- Prevention and Treatment of Intestinal Failure-Associated Liver Disease in Children.Nutrients · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo assess the effectiveness of postoperative feeding guidelines in reducing the incidence and severity of intestinal failure-associated liver disease (IFALD) among infants. STUDY
designTwo cohorts of infants <6 months old undergoing intestinal surgery were compared: preguideline (retrospective data from 2007 to 2013; n = 83) and postguideline (prospective data from 2013 to 2016; n = 81). The guidelines included greater initial enteral nutrition volumes of 20 mL/kg/d and daily feeding advancement if tolerated. The primary outcomes were incidence of IFALD (peak direct bilirubin [DB] >2 mg/dL) and severity (DB >5 mg/dL for moderate-severe). Multiple logistic regression was used to determine the odds of developing IFALD. Other outcomes were time to reach 50% and 100% goal calories from enteral nutrition and the incidence of necrotizing enterocolitis after feeding.
resultsThe incidence of IFALD decreased from 71% to 51% (P = .031), and median peak DB decreased from 5.7 to 2.4 mg/dL (P = .001). After adjusting for diagnosis and prematurity, the odds of developing IFALD of any severity were reduced by 60% (OR 0.40, 95% CI 0.20-0.85), and the odds of developing moderate-to-severe IFALD were reduced by 72% (OR 0.28, 95% CI 0.13-0.58) with guideline use. Time to reach 50% enteral nutrition decreased from a median of 10 to 6 days (P = .020) and time to reach 100% enteral nutrition decreased from 35 to 21 days (P = .035) with guideline use. The incidence of necrotizing enterocolitis after initiating enteral nutrition did not change (5% vs 9%, P = .346).
conclusionsImplementation of feeding guidelines reduced time to reach feeding goals, significantly reducing IFALD incidence and severity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.