Background & Objectives

As intestinal failure (IF) inhibits the digestive system from absorbing nutrients, total parenteral nutrition (TPN) is required to provide all of a person's nutritional demands. In children with malabsorptive conditions like IF, iron deficiency anemia (IDA) is common. This study used a quasi-experimental approach to assess the efficacy and safety of oral iron therapy in treating IDA in TPN-dependent children with IF.

Materials and Methods

Sixteen pediatric patients with an ongoing history of IF, TPN dependency, and iron deficiency anemia were enrolled and given an oral iron syrup dose of ferric hydroxide polymaltose complex (6 mg/kg/day in 2–3 separate doses of elemental iron) after receiving ethical approval and parental consent. Blood tests were done to measure serum iron, ferritin, complete iron-binding capacity [TIBC], transferrin saturation [TSAT], and hemoglobin (Hb) level at the time of inclusion (T0), 14 (T14), and 30 days after treatment (T30).

Results

The mean age was 7.13 (±1.99) and female were 12 (75%). No remarkable change in Hb level was noted in the first and second subsequent follow-ups, notwithstanding, the normal estimation of the serum ferritin level significantly increased during the first follow-up (on fourteenth day) which further enhanced by second follow-up (30th day). The aggregate of the total iron binding capacity (TIBC) declined during the course of oral iron therapy with a reduction in transferrin saturation.

Interpretation & Conclusion

The data suggest that oral iron therapy is unsuccessful in the treatment of IDA in children with IF. There is no substantial improvement in hemoglobin level or iron profile aside from serum ferritin. In order to avoid using parenteral iron in IF patients, an additional supportive system is needed to aid in the integration of oral iron therapy.

中文翻译：

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口服铁剂在治疗肠功能衰竭儿童缺铁性贫血中的应用

背景和目标

由于肠衰竭 (IF) 会抑制消化系统吸收营养，因此需要全胃肠外营养 (TPN) 来满足一个人的所有营养需求。在患有 IF 等吸收不良疾病的儿童中，缺铁性贫血 (IDA) 很常见。本研究使用准实验方法来评估口服铁剂治疗 TPN 依赖性 IF 儿童 IDA 的有效性和安全性。

材料和方法

16 名有持续 IF、TPN 依赖和缺铁性贫血病史的儿科患者被纳入研究，并在接受治疗后给予口服铁糖浆剂量的氢氧化铁聚麦芽糖复合物（6 毫克/千克/天，分 2-3 次单独剂量的元素铁）伦理批准和父母同意。进行血液检查以测量纳入时 (T0)、14 (T14) 和 30 天后的血清铁、铁蛋白、完全铁结合能力 [TIBC]、转铁蛋白饱和度 [TSAT] 和血红蛋白 (Hb) 水平。治疗（T30）。

结果

平均年龄为 7.13 (±1.99) 岁，女性为 12 (75%)。在随后的第一次和第二次随访中没有注意到 Hb 水平的显着变化，尽管在第一次随访期间（第 14 天）血清铁蛋白水平的正常估计值显着增加，并通过第二次随访进一步增强（第 30 天）。在口服铁剂治疗过程中，总铁结合能力 (TIBC) 总量下降，转铁蛋白饱和度降低。

解释与结论

数据表明口服铁剂治疗 IF 儿童 IDA 是不成功的。除了血清铁蛋白外，血红蛋白水平或铁谱没有实质性改善。为了避免在 IF 患者中使用肠外铁剂，需要一个额外的支持系统来帮助整合口服铁剂治疗。