Document Detail


Could lipid infusion be a risk for parenteral nutrition-associated cholestasis in low birth weight neonates?
MedLine Citation:
PMID:  17436017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To assess whether lipid infusion could be a risk factor for parenteral nutrition-associated cholestasis (PNAC) in low birth weight neonates, 22 newborns with cholestasis (29.8 +/- 1.6 weeks, 1298 +/- 217 g) were compared with 22 without cholestasis (29.5 +/- 1.7 weeks, 1286 +/- 363 g). The mean level of peak direct bilirubin for the cholestasis group was 4.6 mg/dl compared to 1.2 mg/dl for the noncholestasis group. A univariate analysis revealed that PNAC was significantly related to duration of fasting (p = 0.008) and parenteral nutrition (p < 0.0001), days of antibiotics use (p = 0.025), positive C-reactive protein (p = 0.018) or gastric culture (p = 0.018), and feeding intolerance (p < 0.0001). Total amino acid amount (p < 0.0001), total lipid amount (p < 0.0001), and average daily lipid amount (p = 0.002) were significantly higher in the cholestasis group than in the noncholestasis group. Conversely, prenatal administration of dexamethasone was a significant protective factor of PNAC (p = 0.008). Logistic regression analysis revealed that the cumulative amount of lipid infusion was an independent risk factor for PNAC (p = 0.041; OR 1.174; CI 1.007-1.369). We suggest that decreasing the cumulative load of amino acids and intralipids with early trophic feeding, control of infection, and prenatal administration of dexamethasone could possibly attenuate the severity of PNAC.
Authors:
Jae Il Shin; Ran Namgung; Min Soo Park; Chul Lee
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Publication Detail:
Type:  Journal Article     Date:  2007-04-14
Journal Detail:
Title:  European journal of pediatrics     Volume:  167     ISSN:  1432-1076     ISO Abbreviation:  Eur. J. Pediatr.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2007-12-24     Completed Date:  2008-05-22     Revised Date:  2009-04-16    
Medline Journal Info:
Nlm Unique ID:  7603873     Medline TA:  Eur J Pediatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  197-202     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, 134 Shinchon-Dong, Seodaemun-Ku, C.P.O. Box 8044, 120-752, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Cholestasis / etiology*
Energy Intake
Humans
Infant, Low Birth Weight*
Infant, Newborn
Infant, Premature, Diseases / therapy
Infant, Small for Gestational Age
Lipids / administration & dosage*,  adverse effects
Logistic Models
Multivariate Analysis
Parenteral Nutrition / adverse effects*
Retrospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Lipids
Comments/Corrections
Comment In:
Eur J Pediatr. 2009 Jan;168(1):123; author reply 125   [PMID:  18575888 ]

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