This year, the PAIR program earned the American Society for Parenteral and Enteral Nutrition (ASPEN) Clinical Nutrition Team of Distinction Award. One of ASPEN’s most prestigious awards, the team-based distinction recognizes “excellence in interdisciplinary clinical nutrition practice.”
Riley Children’s is one of the few hospitals nationwide—and the only facility in Indiana—to offer a comprehensive, multidisciplinary care program for children with intestinal failure. PAIR provides access to novel lipids and new and emerging medical therapies, including intestinal growth factors to promote intestinal adaptation. When the need arises, the PAIR team works closely with the expert pediatric abdominal transplant surgery team at Riley Children’s—one of only eight centers in the nation to perform pediatric intestine or multivisceral transplants in 2022.
“Over the past decade, our PAIR team has worked to build our expertise and to continually advance our clinical practice through the development of evidence-based protocols and a commitment to quality improvement,” said Charles Vanderpool, MD, pediatric gastroenterologist and medical director of nutrition support at Riley Children’s. “The strength of our program lies in the expertise drawn from across our hospital—GI and liver specialists, surgeons, nurse specialists, dietitians, pharmacists and others—who contribute as members of our team in caring for children with highly complex medical and nutritional needs.”
Riley’s PAIR team has led the introduction of protocols focusing on safe administration of parenteral nutrition and newer lipid emulsions and protocols designed to help prevent complications, including liver disease. A recent clinical study conducted at Riley Children’s, “Lipid strategies to prevent intestinal failure-associated liver disease in neonates: A pilot trial,” earned ASPEN’s Harry M. Vars Award for the leading abstract submitted to ASPEN in 2022. PAIR team members also conducted a published review of pediatric patients receiving Smoflipid therapy that evaluated patient response and highlighted safety concerns.
Successful home monitoring program
Initiated by the Riley PAIR team in 2021, the SMART PAIR (Short bowel Monitoring at Residence Through PAIR) program allows patients to return home sooner while still receiving detailed monitoring and timely recommendations on feeding and IV nutrition.
“We're also developing a weekly text update program that’s sent to families requesting that they text an update back to us with how they are doing,” explained Dr. Vanderpool. “With these initiatives, we can continue to make advancements or changes in the care plan based on real data with the patient at home and not in the hospital.”
At any one time, the Riley PAIR teams monitors 30 to 40 patients on home parenteral nutrition. The team also follows “graduates” of the home parenteral nutrition (HPN) program, many of whom still require individualized nutrition plans and monitored nutritional supplementation. To help ensure life-sustaining resources for patients on HPN, the PAIR team is a leader in navigating and managing nutrition shortages and recalls. PAIR team members also participate in the education of residents, fellows and students across all disciplines at Riley Children’s.