{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:44:17Z","timestamp":1782924257716,"version":"3.54.5"},"reference-count":60,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T00:00:00Z","timestamp":1708560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Paediatric patients with high\u2010output ileostomies (HOI) face an elevated risk of complications. This study aimed to comprehensively review the existing literature and offer nutritional management recommendations for paediatric patients with an HOI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed and Embase were searched for relevant English or French language papers up to 31 June 2022. The emphasis was placed on studies involving paediatric ileostomy patients, but insights were obtained from adult literature and other intestinal failure pathologies when these were lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 16 papers that addressed nutritional issues in paediatric ileostomy patients. Currently, no evidence supports a safe paediatric HOI threshold exceeding 20\u2009mL\/kg\/day on two consecutive days. Paediatric HOI patients were at risk of dehydration, electrolyte disturbances, micronutrient deficiencies and growth failure. The primary dietary choice for neonates is bolus feeding with breastmilk. In older children, an enteral fluid restriction should be installed favouring isotonic or slightly hypotonic glucose\u2010electrolyte solutions. A diet that is high in calories, complex carbohydrates and proteins, low in insoluble fibre and simple carbohydrates, and moderate in fat is recommended.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adequate nutritional management is crucial to prevent complications in children with an HOI. Further research is needed to establish more evidence\u2010based guidelines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.17163","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T04:54:33Z","timestamp":1708664073000},"page":"861-870","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Nutritional management of high\u2010output ileostomies in paediatric patients is vital and more evidence\u2010based guidelines are needed"],"prefix":"10.1111","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6028-4081","authenticated-orcid":false,"given":"Marijke","family":"Awouters","sequence":"first","affiliation":[{"name":"Department of Paediatrics University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Vanuytsel","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"Huysentruyt","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology Universitair Ziekenhuis Brussel  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"De\u00a0Bruyne","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology Ghent University Hospital  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9882-8273","authenticated-orcid":false,"given":"Karen","family":"Van\u00a0Hoeve","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilse","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12252"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1313346"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00431-019-03440-6"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.12998\/WJCC.V6.I16.1101"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/ARCHDISCHILD-2016-311126"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2020.1712926"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.4.4.322"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1015062712767"},{"issue":"5","key":"e_1_2_12_10_1","first-page":"146","article-title":"Managing newborn ileostomies","volume":"107","author":"Crealey M","year":"2014","journal-title":"Ir Med J"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JPEDSURG.2020.05.027"},{"key":"e_1_2_12_12_1","unstructured":"LargeB EnglandR MorrisM\u2010A BriarsG.Trust Guideline for the Management of Stoma Output in Neonates and Infants.2020."},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2007.02.009"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedneo.2014.01.001"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjon.2012.21.Sup6.S22"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2013-100375"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12937-015-0034-z"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-971977"},{"issue":"3","key":"e_1_2_12_19_1","first-page":"92","article-title":"Osmolality and pH of sport and other drinks available in Switzerland","volume":"54","author":"Mettler S","year":"2006","journal-title":"Schweizerische Zeitschrift Fur Sport Und Sport"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7304.81"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.33.4.479"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.11124\/JBIES-20-00377"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.3.3.219"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(88)80370-1"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-014-3619-2"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533614528543"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/BCR-2021-241570"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.02.057"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(83)80175-9"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/40.3.628"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.3390\/NU8070444"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009402.PUB3"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedhc.2021.03.003"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-019-03519-0"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.24875\/RIC.20000208"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002596"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu4091273"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtemb.2012.03.015"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1982.tb03914.x"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.CLNU.2022.02.015\/ATTACHMENT\/9B661686-E2BB-4E5E-845B-904356BF7475\/MMC2.PDF"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.114481"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10565"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15010062"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.3390\/NU8080477"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474124.2017.1335196"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.2002.tb07916.x"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.1998.tb00739.x"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2013.01.023"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2007.07.004"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.02.002"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.43.4.478"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181d336d2"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(81)80318-6"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2016.03.009"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-006-0022-7"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10089"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.NUT.2022.111758"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-013-0983-1"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.31.4.435"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04237.x"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1111\/CODI.12992"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.17163","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T13:49:11Z","timestamp":1721224151000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.17163"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,22]]},"references-count":60,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/apa.17163"],"URL":"https:\/\/doi.org\/10.1111\/apa.17163","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,22]]},"assertion":[{"value":"2023-09-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}