Submitted to: Book Chapter
Publication Type: Book / Chapter
Publication Acceptance Date: 12/10/2004
Publication Date: N/A
Interpretive Summary: Not required for a book chapter.
Technical Abstract: The development and maturation of the gastrointestinal tract and its adaptation to major insult such as surgical resection constitute areas of primary interest in relation to the use of parenteral nutrition in the human infant. Parenteral nutrition may have profound effects on the maturation and adaptation of the gastrointestinal tract. Parenteral nutrition may alter the structural integrity and the functional activity of the intestines, liver, and pancreas. However, the adverse consequences of parenteral nutrition may be species-specific and may have fewer implications for humans compared with animal models. Although parenteral nutrition may be life-saving, the nutritional mechanisms that promote the maturation and adaptation of the digestive, absorptive, and immunologic function of the gut under clinical conditions where the intestine is immature or where its reserve capacity has been lost is incompletely understood. The adverse effects of parenteral nutrition on the maturation and adaptation of the gut are thought to reflect the absence of luminal factors such as biliary and pancreatic secretions, individual nutrients, hormones, and growth factors, even if parenteral nutrition is maintained. Nevertheless, parenteral nutrition is the mainstay of treatment for premature infants and infants with massive bowel resection who cannot be fed enterally. In the final analysis, parenteral nutrition prevents progressive malnutrition, initiates mucosal hyperplasia, and supports the absorptive and immunologic capacity of the small bowel in children with special nutritional needs.