Etiologies, nutritional support and clinical outcomes of intestinal failure at Children’s Hospital 2 in 2020–2024

Intestinal failure (IF) is a severe condition requiring complex nutritional management, but evidence from Vietnam remains limited. This study aimed to determine etiologies, nutritional support, and clinical outcomes in children with IF. We conducted a case series study of pediatric patients with IF at Children’s Hospital 2 (January 2020–May 2024). Data were collected with a standardized form, and anthropometry analyzed using World Health Organization (WHO) Anthro/AnthroPlus software. A total of 68 patients (51.5% male) had a median age of 3.5 (2.1–6.2) months at IF diagnosis. Primary etiologies were short bowel syndrome (SBS) (76.5%), mucosal enteropathies (14.7%), and motility disorders (8.8%). For parenteral nutrition (PN), maximum volume, energy and energy-to-resting energy expenditure ratio respectively were 134.3 (111.4–163) mL/kg/day, 88.1 (79.7–96.2) kcal/kg/day, 1.69 (1.48–1.99). For enteral nutrition, corresponding values were 103.4±38.3 mL/kg/day, 80 (58.1–90.8) kcal/kg/day, and 1.46 (1.05–1.67). After PN, acute malnutrition (68.1% to 25%) and hypoalbuminemia (77.9% to 38.2%) decreased, whereas underweight (39.1% to 56.3%) and chronic malnutrition (25% to 41.2%) increased (p<0.05). At first discharge, PN discontinuation was 51/68 (75%), mortality was 17/68 (25.0%). Final follow-up at the median age (Q1–Q3) of 28.3 (12–48.7) months presented 7 patients lost to follow-up, whereas successful PN weaning was 29/61 (47.5%), readmission was 27/61 (44.3%), and overall mortality was 18/61 (29.5%), mainly from septic shock. SBS was the leading cause of IF. Despite short-term nutritional improvement, long-term outcomes were suboptimal, indicating more aggressive management.