Document Detail


Incidence and risk factors of parenteral nutrition-associated liver disease in newborn infants.
MedLine Citation:
PMID:  22449297     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective:  To determine the incidence and risk factors of parenteral nutrition-associated liver disease (PNALD) in neonates. Materials and Methods:  A 1-year prospective cohort study was carried out at the NICU and sick neonatal wards, Chiang Mai University Hospital. Newborns of >1000 g, receiving >7 days of parenteral nutrition (PN), were enrolled. Liver function tests were done by the end of first, second, fourth and then every 4 weeks until the PN was discontinued and the jaundice resolved. The diagnosis of PNALD was relied on a history of receiving PN, direct bilirubin >2 mg/dl, and exclusion of other causes of neonatal cholestasis. Selected patient factors and PN compositions were analyzed to determine the risks for development of PNALD. Results:   A total of 24 cases with a mean gestational age and birth weight of 32.5 weeks and 1840 g were enrolled. Eight of 24 developed PNALD. Compared to those without PNALD, gastrointestinal surgery, duration of enteral starvation, duration of PN, maximum PN caloric intake, and maximum carbohydrate intake were significantly associated with the development of liver disease. Despite no statistical significance, there was a trend towards cholestasis in patients with sepsis. Elevation of direct bilirubin was the earliest biochemical change, observed at the first week after PN, followed by increased transaminases. Conclusion:  Gastrointestinal surgery, duration of enteral starvation, duration of PN, maximum of caloric and carbohydrate intake in PN were significant risks of PNALD in newborn infants. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.
Authors:
Photchanaphorn Koseesirikul; Somporn Chotinaruemol; Nuthapong Ukarapol
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-26
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  -     ISSN:  1442-200X     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.
Affiliation:
Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, THAILAND.
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