Infants and children requiring prolonged parenteral nutrition may receive an intravenous fat in the form of soybean oil, fish oil, or composite lipid emulsion). Depending on patient characteristics, including age, nutritional status, and comorbidities, certain IV lipid emulsions may be preferrable to others.   

Dosing strategies and IV lipid selection rationale are complicated and require an understanding of components of the lipid emulsion and standards for appropriate use – and complications can occur due to gaps in knowledge, skills, and PN prescribing practices.   Many patients on chronic PN warrant close monitoring of their nutritional status and liver health.  

Update on Alternative Lipids will examine the different IV lipid emulsions used, describe the rational for IV lipid emulsion selection, help explain essential fatty acids and deficiencies and offer future direction and application.

Bowel Sounds, Episode Twenty Seven: Aliye Uc - Acute Pancreatitis Pearls

In this episode of Bowel Sounds, hosts Drs. Temara Hajjat and Jason Silverman talk to Dr. Aliye Uc, head of the division of pediatric gastroenterology at the University of Iowa, about her pearls for the evaluation and management of acute and acute recurrent pancreatitis.  She also discusses her journey to becoming an expert in pancreatic diseases in childhood and her inspiration for creating INSPPIRE, a network of medical centers committed to learning more about pediatric pancreatitis.

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

June 2021 Nutrition Pearl: “Step-up” Elimination Diet for EoE.  Nutrition Pearls are sponsored by Mead Johnson.

May 2021 Nutrition Pearl: Introduction to Pediatric Patients with Intestinal Failure.  Nutrition Pearls are sponsored by Mead Johnson.

Bowel Sounds, Episode Twenty Six: Mel Heyman - Advice from an Editor-in-Chief

In this episode, hosts Drs. Temara Hajjat and Jason Silverman talk to former NASPGHAN Editor-in-Chief for JPGN, and current Editor for JPGN Reports, Dr. Mel Heyman.  We discuss his experiences in these roles including the challenges and the rewards, as well as reviewing a number of the key initiatives undertaken during his tenure. 

We also discuss solid advice for aspiring authors, including the most common mistake authors make with their submissions. There is also time for a pitch for being  journal reviewers, particularly for junior faculty. 

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

Bowel Sounds, Episode Twenty Five: Sandra Kim - Treatment of Pediatric IBD... Except the Medications

In this episode of Bowel Sounds, hosts Drs. Peter Lu and Jennifer Lee talk to Dr. Sandra Kim about the treatment of children with inflammatory bowel disease aside from choosing their medications. We discuss challenges patients and parents face and how to choose your words when delivering a new diagnosis. We discuss how to explain biosimilars to families and and how to get involved in the advocacy efforts with NASPGHAN and Crohn's and Colitis Foundation. 

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

The Institute of Medicine (IOM) defines quality in health care as “a direct correlation between the level of improved health services and the desired health outcomes of individuals and populations” (A Strategy for Quality Assurance. IOM. Natl Acad Press. Washington DC,1990). Paul Batalden et al. define quality in healthcare as “the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning)” (Qual Saf Health Care 2007;16:2–3). Quality improvement (QI) consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted populations.  

In other words, it’s an attitude mindset, and skill set that is geared towards improvement in care delivery processes, outcomes, clinical and business operations, and cost.

It aligns well with Institute of HealthCare Improvement’s approach to optimizing health system performance as defined by the Quadruple Aim by enhancing patient experience, improving population health, reducing costs, and improving the work life of health care providers, including clinicians and staff. Health systems are increasingly recognizing the central role QI expertise can play in daily functions and efficiencies.

Integrating QI into your Practice and Career will focus on QI from the perspectives of physicians early in their career to those in senior leadership, including leadership development, clinical efficiencies, and improving the chronic care delivery system. Practical examples of specific projects in different areas of gastroenterology care will be discussed, including the identification of nutritional deficiencies, and mitigation strategies, and chronic disease management. Research opportunities in QI as a career focus and grant funding will also be highlighted. 

April 2021 Nutrition Pearl: Nutrition Support of Children with Chronic Liver Disease Pt 1.  Nutrition Pearls are sponsored by Mead Johnson.

Bowel Sounds, Episode Twenty Four: Carlo Di Lorenzo - Can My Tweets/Blog/Podcast Get Me Promoted?

In a special episode of Bowel Sounds recorded LIVE at the 36th Annual Meeting of the Society for Pediatric Gastroenterology and Nutrition (Gesellschaft für pädiatrische Gastroenterologie und Ernährung) originally to be held in Basel, Switzerland, hosts Drs. Peter Lu and Jennifer Lee talk to former NASPGHAN President Dr. Carlo Di Lorenzo (our guest from our very first episode) about how digital media -- including social media, blogs, podcasts, and other formats -- is changing academic medicine. 

We discuss the rise of digital media for teaching, promoting research, and building community in pediatric gastroenterology. We discuss whether social media posts and podcasts should be factored into academic productivity and promotion. We also answer questions from the audience about why pediatric gastroenterologists should engage in social media and how to address misinformation.

As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.

Neonates, particularly preterm neonates who are born with significant nutrient deficits, accumulate increasing nutrient deficits during their stay in neonatal intensive care.

Updating Neonatal Parenteral Nutrition: Now and the Future will review recent international guidelines for the management of parenteral nutrition support, discuss the considerations in the optimal balance of amino acids for neonatal growth and review the evidence for use of parenteral lipids to better meet essential fatty acid requirements critical for neurodevelopment.  Controversies in the timing of parenteral nutrition support and how new approaches to support transitioning to enteral nutrition might improve growth outcomes in the NICU will also be discussed.