| Elimination of soybean lipid emulsion in parenteral nutrition and supplementation with enteral fish oil improve cholestasis in infants with short bowel syndrome. | |
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MedLine Citation:
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PMID: 20413701 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Parenteral nutrition-associated liver disease (PNALD) is a potentially fatal complication for children with intestinal failure. Fish oil-based lipid emulsions have shown promise for the treatment of PNALD but are not readily available. Six cases are presented in which cholestasis resolved after soybean lipid emulsion (SLE) was removed from parenteral nutrition (PN) and enteral fish oil was given. METHODS: A retrospective review at a tertiary children's hospital (July 2003 to August 2008) identified 6 infants with intestinal failure requiring PN for >6 months who developed severe hepatic dysfunction that was managed by eliminating SLE and providing enteral fish oil. RESULTS: Twenty-three infants with short bowel syndrome requiring prolonged PN developed cholestasis. SLE was removed in 6 of these patients, and 4 of the 6 received enteral fish oil. Standard PN included 2-3 g/kg/d SLE with total PN calories ranging from 57 to 81 kcal/kg/d at the time of SLE removal. Hyperbilirubinemia resolved after elimination of SLE within 1.8-5.4 months. Total PN calories required to maintain growth generally did not change. CONCLUSIONS: Temporary elimination of SLE and supplementation with enteral fish oil improved cholestasis in PN-dependent infants. Further trials are needed to evaluate this management strategy. |
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Authors:
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Michael D Rollins; Eric R Scaife; W Daniel Jackson; Rebecka L Meyers; Cecilia W Mulroy; Linda S Book |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition Volume: 25 ISSN: 1941-2452 ISO Abbreviation: Nutr Clin Pract Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-23 Completed Date: 2010-07-19 Revised Date: 2010-07-28 |
Medline Journal Info:
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Nlm Unique ID: 8606733 Medline TA: Nutr Clin Pract Country: United States |
Other Details:
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Languages: eng Pagination: 199-204 Citation Subset: IM; N |
Affiliation:
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Children's Medical Center, University of Utah, Salt Lake City, Utah 84113-1103, USA. michael.rollins@hsc.utah.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cholestasis
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etiology,
therapy* Enteral Nutrition Fat Emulsions, Intravenous / adverse effects, chemistry*, therapeutic use Fish Oils / adverse effects, therapeutic use* Humans Infant Infant, Newborn Parenteral Nutrition / adverse effects, methods* Retrospective Studies Short Bowel Syndrome / complications, therapy* Soybean Oil / adverse effects Soybeans Survival Rate Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Fat Emulsions, Intravenous; 0/Fish Oils; 8001-22-7/Soybean Oil |
| Comments/Corrections | |
Erratum In:
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Nutr Clin Pract. 2010 Jun;25(3):315 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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