It isn’t everyday that babies and pediatric surgeons make the front page of the Wall Street Journal. Today’s issue makes interesting reading and tells the tale Dr. Mark Puder at Boston Children's Hospital. He has been hot on the trail of a new variety of intravenous nutrition to treat short bowel syndrome. Short bowel syndrome, or short gut syndrome, is a chronic condition characterized by diminished bowel length that precludes normal feeding. Many babies with short gut require intravenous nutrition over the first few years of their lives. Long-term use of IV nutrition in children with short gut causes the stagnation of bilirubin (cholestasis) in the liver. This ultimately causes fibrosis, liver failure and death during the first few years of life.
In a study published in Pediatrics this July, Dr. Puder and colleagues reported successful reversal of cholestasis in two short gut babies using a Omegaven, an intravenous fat source supplemented with omega-3 fatty acids. While a controlled clinical trial is needed, it represents a glimmer of hope for the thousands of babies afflicted with this horrendous problem.
While the WSJ story is only available to subscribers, it makes interesting reading that almost matches something seen on Grey's Anatomy or House. Beyond the institutional soft shoe of adopting an experimental therapy, there’s the wrinkle of a manufacturer (Fresenius Kabi AG) who isn’t interested in pursuing further clinical studies with Omegaven (Point of Law has an interesting explanation). Despite the fact that Dr. Puder has fallen out of Boston's grace by referring to currently used IV nutrition as "white poison," he sounds like someone with real chutzpah.