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Could lipid infusion be a risk for parenteral nutrition-associated cholestasis in low birth weight neonates?

Authors
 Jae Il Shin  ;  Ran Namgung  ;  Min Soo Park  ;  Chul Lee 
Citation
 EUROPEAN JOURNAL OF PEDIATRICS, Vol.167(2) : 197-202, 2008 
Journal Title
 EUROPEAN JOURNAL OF PEDIATRICS 
ISSN
 0340-6199 
Issue Date
2008
MeSH
Cholestasis/etiology* ; Energy Intake ; Humans ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Premature, Diseases/therapy ; Infant, Small for Gestational Age ; Lipids/administration & dosage* ; Lipids/adverse effects ; Logistic Models ; Multivariate Analysis ; Parenteral Nutrition/adverse effects* ; Retrospective Studies ; Risk Factors
Keywords
Total parenteral nutrition ; Cholestasis ; Low birth weight neonates ; Lipid
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
Full Text
http://link.springer.com/article/10.1007%2Fs00431-007-0454-7
DOI
10.1007/s00431-007-0454-7
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Namgung, Ran(남궁란) ORCID logo https://orcid.org/0000-0001-7182-9535
Park, Min Soo(박민수) ORCID logo https://orcid.org/0000-0002-4395-9938
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
Lee, Chul(이철)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107255
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