Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 197-202 |
| Number of pages | 6 |
| Journal | European Journal of Pediatrics |
| Volume | 167 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2008 Feb 1 |
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All Science Journal Classification (ASJC) codes
- Pediatrics, Perinatology, and Child Health
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Could lipid infusion be a risk for parenteral nutrition-associated cholestasis in low birth weight neonates? / Shin, Jaeil; Namgung, Ran; Park, Min Soo; Lee, Chul.
In: European Journal of Pediatrics, Vol. 167, No. 2, 01.02.2008, p. 197-202.Research output: Contribution to journal › Article
TY - JOUR
T1 - Could lipid infusion be a risk for parenteral nutrition-associated cholestasis in low birth weight neonates?
AU - Shin, Jaeil
AU - Namgung, Ran
AU - Park, Min Soo
AU - Lee, Chul
PY - 2008/2/1
Y1 - 2008/2/1
N2 - 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.
AB - 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.
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U2 - 10.1007/s00431-007-0454-7
DO - 10.1007/s00431-007-0454-7
M3 - Article
VL - 167
SP - 197
EP - 202
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
SN - 0340-6199
IS - 2
ER -