28 statements
· 2 topics
· summaries given as host listed separately
Featured statements
▶Ep 3 · 19:44
Timing for intestinal lengthening procedure is considered around one year of age when the intestine is wide enough to perform the procedure and when the patient has stalled on feedings
Establishing intestinal continuity as soon as possible is imperative because it allows enteral nutrition to start with human milk, which helps with intestinal rehabilitation
clinicalThe PDC communicates with the American Board of Surgery and provides information for continuous certification↗
▶Ep 3 · 0:28
clinicalThe APSA Professional Development Committee was established approximately five years ago to curate information from journals, blogs, and guidelines↗
▶Ep 3 · 6:31
quotethe way that we could get to the best possible outcomes is um by engaging the family, respecting their beliefs, listening to them↗
▶Ep 3 · 9:12
clinicalFamily-centered care is cost effective and decreases legal claims and legal expenses↗
▶Ep 3 · 9:12
clinicalFamily-centered care reduces ED visits, decreases anxiety in parents and children, reduces length of stay, reduces medical errors, and improves staff satisfaction↗
▶Ep 3 · 14:10
clinicalIntestinal transplantation is becoming less common because centers are getting very good at intestinal rehabilitation↗
▶Ep 3 · 14:10
clinicalEstablishing intestinal continuity as soon as possible is imperative because it allows enteral nutrition to start with human milk, which helps with intestinal rehabilitation↗
▶Ep 3 · 18:31
clinicalThe ileocecal valve decreases the occurrence of small bowel bacterial overgrowth, which can impede the ability to increase feeds↗
▶Ep 3 · 19:44
clinicalPPI should be started right away after massive bowel resection, not just when starting feeds↗
▶Ep 3 · 19:44
clinicalTiming for intestinal lengthening procedure is considered around one year of age when the intestine is wide enough to perform the procedure and when the patient has stalled on feedings↗
▶Ep 3 · 20:53
clinicalIntestinal lengthening procedures are becoming rarer due to improvements in medical therapy and intestinal rehabilitation centers↗
▶Ep 3 · 26:17
clinicalButton battery ingestion requires immediate transfer to a pediatric center and removal under direct visualization in the operating room↗
▶Ep 3 · 26:17
quotethis strikes fear in my heart as much as a level one trauma gunshot to the got, you know, cavity of something↗
▶Ep 3 · 26:17
clinicalButton batteries create both an alkali burn and an electrical burn in the esophagus↗
Marjorie's statements about Midgut Volvulus14 statements
clinicalThe APSA Professional Development Committee was established approximately five years ago to curate information from journals, blogs, and guidelines↗
▶Ep 3 · 0:28
clinicalThe PDC communicates with the American Board of Surgery and provides information for continuous certification↗
▶Ep 3 · 6:31
quotethe way that we could get to the best possible outcomes is um by engaging the family, respecting their beliefs, listening to them↗
▶Ep 3 · 9:12
clinicalFamily-centered care reduces ED visits, decreases anxiety in parents and children, reduces length of stay, reduces medical errors, and improves staff satisfaction↗
▶Ep 3 · 9:12
clinicalFamily-centered care is cost effective and decreases legal claims and legal expenses↗
▶Ep 3 · 14:10
clinicalIntestinal transplantation is becoming less common because centers are getting very good at intestinal rehabilitation↗
▶Ep 3 · 14:10
clinicalEstablishing intestinal continuity as soon as possible is imperative because it allows enteral nutrition to start with human milk, which helps with intestinal rehabilitation↗
▶Ep 3 · 18:31
clinicalThe ileocecal valve decreases the occurrence of small bowel bacterial overgrowth, which can impede the ability to increase feeds↗
▶Ep 3 · 19:44
clinicalTiming for intestinal lengthening procedure is considered around one year of age when the intestine is wide enough to perform the procedure and when the patient has stalled on feedings↗
▶Ep 3 · 19:44
clinicalPPI should be started right away after massive bowel resection, not just when starting feeds↗
▶Ep 3 · 20:53
clinicalIntestinal lengthening procedures are becoming rarer due to improvements in medical therapy and intestinal rehabilitation centers↗
▶Ep 3 · 26:17
quotethis strikes fear in my heart as much as a level one trauma gunshot to the got, you know, cavity of something↗
▶Ep 3 · 26:17
clinicalButton battery ingestion requires immediate transfer to a pediatric center and removal under direct visualization in the operating room↗
▶Ep 3 · 26:17
clinicalButton batteries create both an alkali burn and an electrical burn in the esophagus↗
Summaries Marjorie gave as host
· 22 summaries
Recaps of other experts' statements, not Marjorie's own clinical position.
Summaries Marjorie gave as host · Ingestion of Foreign Bodies11 summaries
host summaryMarjorie Arca summarizing the discussion: Factors associated with achieving enteral autonomy include longer residual small bowel, younger age at time of intestinal resection, preservation of the ileocecal valve, diagnosis other than necrotizing enterocolitis, absence of liver disease, and normal gastrointestinal motility↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Omegaven can be used when liver function tests go up and there is evidence of liver dysfunction, but it can decrease the amount of lipids the patient receives↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Intestinal lengthening procedures should be delayed for a few months until adaptation starts because this allows more length to be gained from the remaining bowel↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Teduglutide (glucagon-like peptide 2) increases epithelial proliferation and has been approved in children, but outcomes are not as impactful as in adults because outcomes measured are number of hours off TPN rather than days↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: After massive small bowel resection, there is reflex hypergastrinemia that impacts feeding tolerance, and PPI or H2 blockers are recommended with strong recommendation and high level of evidence↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Amino acid based formulas have more favorable outcomes than protein hydrolysis formulas when human milk is not available↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Human milk (mother's expressed breast milk or donor milk) is associated with fewer days of parenteral nutrition and is protective for the liver↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Current NASPGHAN and ESPGHAN guidelines recommend starting enteral nutrition and advancing enteral feeding as soon as possible to help with intestinal rehabilitation↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Guidelines recommend using SMOF lipids (four combination lipids of soy, fish oil, olive oil, and medium chain triglyceride oil) for parenteral nutrition as they are protective↗
▶Ep 3 · 26:17
host summaryMarjorie Arca summarizing the discussion: For button battery ingestion in children less than 12 months old, give sucralfate suspension 1 gram per 10 ml or 10 ml every hour times 3↗
▶Ep 3 · 26:17
host summaryMarjorie Arca summarizing the discussion: For button battery ingestion in children greater than 12 months old, give honey 10 ml every 10 minutes while arranging transfer↗
Summaries Marjorie gave as host · Midgut Volvulus11 summaries
host summaryMarjorie Arca summarizing the discussion: Factors associated with achieving enteral autonomy include longer residual small bowel, younger age at time of intestinal resection, preservation of the ileocecal valve, diagnosis other than necrotizing enterocolitis, absence of liver disease, and normal gastrointestinal motility↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Intestinal lengthening procedures should be delayed for a few months until adaptation starts because this allows more length to be gained from the remaining bowel↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Teduglutide (glucagon-like peptide 2) increases epithelial proliferation and has been approved in children, but outcomes are not as impactful as in adults because outcomes measured are number of hours off TPN rather than days↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: After massive small bowel resection, there is reflex hypergastrinemia that impacts feeding tolerance, and PPI or H2 blockers are recommended with strong recommendation and high level of evidence↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Omegaven can be used when liver function tests go up and there is evidence of liver dysfunction, but it can decrease the amount of lipids the patient receives↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Guidelines recommend using SMOF lipids (four combination lipids of soy, fish oil, olive oil, and medium chain triglyceride oil) for parenteral nutrition as they are protective↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Amino acid based formulas have more favorable outcomes than protein hydrolysis formulas when human milk is not available↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Human milk (mother's expressed breast milk or donor milk) is associated with fewer days of parenteral nutrition and is protective for the liver↗
▶Ep 3 · 14:10
host summaryMarjorie Arca summarizing the discussion: Current NASPGHAN and ESPGHAN guidelines recommend starting enteral nutrition and advancing enteral feeding as soon as possible to help with intestinal rehabilitation↗
▶Ep 3 · 26:17
host summaryMarjorie Arca summarizing the discussion: For button battery ingestion in children less than 12 months old, give sucralfate suspension 1 gram per 10 ml or 10 ml every hour times 3↗
▶Ep 3 · 26:17
host summaryMarjorie Arca summarizing the discussion: For button battery ingestion in children greater than 12 months old, give honey 10 ml every 10 minutes while arranging transfer↗
