243 Impact of presence, level and closure of a stoma on growth in young children Chapter 11 Urinary sodium levels were obtained from spot urinary samples obtained after the stoma creation. The current regime at our institute is to evaluate urinary sodium 2-3 times a week and to start supplementation if urinary sodium < 30 mmol/L. Following stoma formation, the lowest urinary sodium measurement for each patient was used defining a urine sodium level of ≤30 mmol/L as deficient, and ≤10 mmol/L as severely deficient.(14, 15, 19) There is no official protocol for sodium supplementation at our institute. However, in general practice, 2 mmol/kg oral sodium chloride daily is started, which could be increased with steps of 1 mmol/kg in case of urine sodium levels ≤30 mmol/L. If after the start of sodium supplementation, the urinary sodium values were more than twice levels ≤30 mmol/L, the sodium supplementation was defined as inadequate. Outcome measures The primary outcome was weight-for-age Z-scores. Comparative analyses of the primary outcome were performed between different time points: at time of creation, closure and within a year after closure. This was reviewed separately for patients with a small bowel stoma and a colostomy. Differences in Z-scores at closure and within a year following closure were compared between the following groups: 1) early and non-early closed stomas, 2) proximal and non-proximal small bowel stomas 3) patients who received a major small bowel resection (larger than 30 centimeter) and those that did not 4) adequate versus non-adequate supplementation of sodium Statistical analysis Descriptive data were reported with a median with the interquartile range. Comparison of changes in Z-scores following stoma closure and a year after closure was done by Friedman test with post-hoc Wilcoxon signed-rank test in case of significant results. Comparison between the characteristics of young children with a small bowel stoma and a colostomy were performed with chi-square tests for categorical data, T-tests for parametric continuous data and the Mann-Whitney U tests for non-parametric continuous data. Comparison of changes in Z-scores following stoma closure and a year after closure was done by Wilcoxon rank sum test for all secondary outcome measures. Comparisons of Z-scores at stoma closure between different groups at closure or at a year following closure was done by Mann-Whitney U tests. All analyses were performed with IBM SPSS statistics, version 23 (IBM Corp., Armonk, NY, United States).
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