Document Detail


Elimination of soybean lipid emulsion in parenteral nutrition and supplementation with enteral fish oil improve cholestasis in infants with short bowel syndrome.
MedLine Citation:
PMID:  20413701     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Michael D Rollins; Eric R Scaife; W Daniel Jackson; Rebecka L Meyers; Cecilia W Mulroy; Linda S Book
Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2010-04-23     Completed Date:  2010-07-19     Revised Date:  2010-07-28    
Medline Journal Info:
Nlm Unique ID:  8606733     Medline TA:  Nutr Clin Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  199-204     Citation Subset:  IM; N    
Affiliation:
Children's Medical Center, University of Utah, Salt Lake City, Utah 84113-1103, USA. michael.rollins@hsc.utah.edu
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MeSH Terms
Descriptor/Qualifier:
Cholestasis / 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:
0/Fat Emulsions, Intravenous; 0/Fish Oils; 8001-22-7/Soybean Oil
Comments/Corrections
Erratum In:
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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