Consenso colombiano basado en la evidencia para el manejo de falla intestinal secundaria a síndrome de intestino corto en pediatría
DOI:
https://doi.org/10.22516/25007440.1390Palabras clave:
Insuficiencia intestinal, síndrome del intestino corto, nutrición parenteral, nutrición enteral, teduglutidaResumen
Introducción: la insuficiencia intestinal secundaria al síndrome de intestino corto en pediatría conlleva a malabsorción, trastornos metabólicos y necesidad frecuente de nutrición parenteral. La variabilidad clínica y su manejo terapéutico requieren la implementación de una guía de práctica clínica local.
Objetivo: proporcionar recomendaciones basadas en la evidencia, con énfasis en la evaluación temprana, selección terapéutica adecuada y seguimiento a largo plazo.
Metodología: un grupo multidisciplinario de 25 expertos formularon 12 preguntas. A través de una revisión sistemática de la literatura de forma independiente y su análisis, formularon recomendaciones aplicando la metodología Delphi modificada para alcanzar el consenso.
Resultados: se tamizaron 1124 referencias. Se incluyeron 38 en la síntesis de la evidencia (20 revisiones sistemáticas, 10 guías y 8 estudios primarios). El panel de expertos formuló 88 recomendaciones. Se identificaron estrategias de manejo sobre el uso de inhibidores de la bomba de protones, procinéticos, antibióticos e implementación de nutrición individualizada. Se recomienda el uso de teduglutida en pacientes con dependencia prolongada de nutrición parenteral y la necesidad de evaluación y seguimiento multidisciplinario para el manejo de complicaciones.
Conclusiones: el manejo de la insuficiencia intestinal secundaria a intestino corto es complejo y requiere un equipo multidisciplinario de rehabilitación intestinal. Se deben individualizar las intervenciones de evaluación, tratamiento farmacológico y quirúrgico, apoyo nutricional y el manejo de sus complicaciones. Este consenso ofrece recomendaciones basadas en evidencia y prácticas estandarizadas para mejorar los resultados clínicos.
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