Document Detail


The Role of Parenteral Lipids in the Development of Advanced Intestinal Failure-Associated Liver Disease in Infants: A Multiple-Variable Analysis.
MedLine Citation:
PMID:  21825088     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Given the recent interest in the role of ω-6 lipids in the development of intestinal failure-associated liver disease (IFALD), the authors sought to examine the role of parenteral lipids in the development of a serum conjugated bilirubin >100 μmol/L (5.9 mg/dL; CB100) in infants. Method: Between 2003 and 2004, data were collected prospectively on infants undergoing an abdominal surgical procedure. Univariate logistic regression models for the prediction of CB100 by 1 year postoperatively were developed. Predictors significant at the 0.2 level on univariate analysis were entered into a backward stepwise multiple variable logistic regression. RESULTS: Of 152 infants who received parenteral nutrition (PN) postoperatively, 22 developed CB100. Predictors that met criteria for consideration in the multiple-variable model were age, weight, small bowel length, presence of a stoma, proportion of enteral feeds postoperatively, septic episodes, days of maximal PN amino acid (>2.5 g/kg/d), days of maximal lipid (>2.5 g/kg/d), and PN duration. The final model included septic episodes (odds ratio, 3.23; 95% confidence interval, 1.8-5.9) and days of lipid >2.5 g/kg/d (1.04; 1.003-1.06). At 60 days of maximal lipid, the odds of advanced IFALD were increased 10-fold. CONCLUSIONS: This model suggests a key role of parenteral lipids and septic events in the development of CB100 from IFALD. These data may provide targets, such as careful line care, reduction in maximal lipid dose, or alternate lipids such as ω-3 fatty acids, to prevent CB100, an identified marker of subsequent liver failure from IFALD. (JPEN J Parenter Enteral Nutr. XXXX;XX:xx-xx).
Authors:
Ivan R Diamond; Nicole T de Silva; George A Tomlinson; Paul B Pencharz; Brian M Feldman; Aideen M Moore; Simon C Ling; Paul W Wales
Related Documents :
11174618 - Sleep position and bed-sharing in sudden infant deaths: an examination of autopsy findi...
11008928 - A review of the status of magnesium and related minerals in the sudden infant death syn...
6751068 - Apnea of infancy and sudden infant death syndrome.
16813458 - Pulmonary intra-alveolar siderophages in sids and suffocation: a san diego sids/sudc re...
13679938 - Effect of recombinant granulocyte colony-stimulating factor on blood neutrophil concent...
22331018 - One-step percutaneous gastrojejunostomy in early infancy.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-8
Journal Detail:
Title:  JPEN. Journal of parenteral and enteral nutrition     Volume:  -     ISSN:  0148-6071     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7804134     Medline TA:  JPEN J Parenter Enteral Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
The Hospital for Sick Children.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Dosing and Monitoring of Trace Elements in Long-Term Home Parenteral Nutrition Patients.
Next Document:  Nutrition in Inflammatory Bowel Disease.