A contemporary analysis of parenteral nutrition–associated liver disease in surgical infants

Javid, Patrick J.; Malone, Frances R.; Dick, A.; Hsu, Evelyn; Sunseri, Maria; Healey, Patrick J.; Horslen, Simon

doi:10.1016/j.jpedsurg.2011.06.002

Cited by 39 publications

(36 citation statements)

References 24 publications

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“…By contemporary analyses, approximately 25% of neonates with gastrointestinal disorders will develop PNALD. 37 The incidence and likelihood of developing PNALD vary by specific gastrointestinal diagnosis and report. 1,37,38 Moreover, PNALD incidence increases significantly when a congenital gastrointestinal diagnosis is complicated by any stage of necrotizing enterocolitis.…”

Section: Parenteral Nutrition-associated Liver Diseasementioning

confidence: 99%

“…37 The incidence and likelihood of developing PNALD vary by specific gastrointestinal diagnosis and report. 1,37,38 Moreover, PNALD incidence increases significantly when a congenital gastrointestinal diagnosis is complicated by any stage of necrotizing enterocolitis. 1,37–41 For children who develop short bowel syndrome (SBS), 67% will develop PNALD and 17% will progress to end-stage liver failure.…”

Section: Parenteral Nutrition-associated Liver Diseasementioning

confidence: 99%

“…1,37,38 Moreover, PNALD incidence increases significantly when a congenital gastrointestinal diagnosis is complicated by any stage of necrotizing enterocolitis. 1,37–41 For children who develop short bowel syndrome (SBS), 67% will develop PNALD and 17% will progress to end-stage liver failure. 42 In addition, prematurity, birth weight, infections, and perhaps an individual’s genetic makeup appear to be important drivers for PNALD.…”

Section: Parenteral Nutrition-associated Liver Diseasementioning

confidence: 99%

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Complications Associated with Parenteral Nutrition in the Neonate

Calkins

Venick

Devaskar

2014

Clinics in Perinatology

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Parenteral nutrition (PN) is essential to the practice of neonatology. While PN is life-sustaining, it associated with a host of complications including parenteral nutrition-associated liver disease (PNALD) and central line-associated bloodstream infections (CLASBIs), which carry a high morbidity and mortality and pose a burden to the healthcare system. Evidence has emerged that the dose and composition of intravenous lipid products can alter the incidence of PNALD and CLASBIs. However, other patient- and PN-related factors, such as prematurity, birth weight, and gastrointestinal anatomy and function, must not be ignored. In order improve neonatal care, future research is still needed to optimize the content of PN and decrease the incidence PNALD and CLASBIs.

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Section: Parenteral Nutrition-associated Liver Diseasementioning

confidence: 99%

Section: Parenteral Nutrition-associated Liver Diseasementioning

confidence: 99%

Section: Parenteral Nutrition-associated Liver Diseasementioning

confidence: 99%

See 1 more Smart Citation

Complications Associated with Parenteral Nutrition in the Neonate

Calkins

Venick

Devaskar

2014

Clinics in Perinatology

View full text Add to dashboard Cite

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“…In another study of premature neonates (median gestational age of 26 weeks), the frequency of PNALD was considerably higher and ranged from 56 to 85 % [ 8 ]. In a retrospective review of 176 premature infants who received PN, cholestasis occurred in 24 % of infants especially in those with lower gestational age (34 vs. 36 weeks; p < 0.01) and those who received longer duration of PN (76 vs. 21 days; p < 0.001) [ 9 ].…”

Section: Epidemiologymentioning

confidence: 99%

“…Its time to onset is diffi cult to accurately predict due to its association with different risk factors. In a retrospective study of premature infants who received PN, the median time to development of cholestasis was 23 days, with 77 % of infants developing cholestasis within 5 weeks of PN initiation [ 9 ]. Biochemical markers of PNAC typically include elevations of serum bilirubin and γ-glutamyl transpeptidase (GGT) concentrations.…”

Section: Cholestasismentioning

confidence: 99%

Parenteral Nutrition-Associated Liver Disease in Pediatric Patients: Strategies for Treatment and Prevention

Blackmer

Btaiche

Arnold

et al. 2013

Diseases of the Liver in Children

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Postoperative Feeding Guidelines Improve Outcomes in Surgical Infants

Shakeel

Newkirk

Sellers

et al. 2019

J Parenter Enteral Nutr

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BackgroundEarly introduction of enteral nutrition (EN) in postoperative infants improves intestinal adaptation, reducing the risk of intestinal failure–associated liver disease (IFALD). Our objective was to determine whether guideline use reduces feeding variability and improves outcomes in the neonatal intensive care unit (NICU).MethodsIn a cohort study, surgical infants at risk for IFALD were evaluated pre and post implementation of feeding guidelines at 2 NICUs. A total of 167 guideline infants (2013–2018) were compared with 242 historical controls (2007–2013). Adherence was measured with timing and volume of initial postoperative feed. Primary outcomes were IFALD incidence and time to reach 50% and 100% of energy from EN. Secondary outcomes were parenteral nutrition (PN) days, postoperative necrotizing enterocolitis (NEC), central line–associated bloodstream infection (CLABSI), and length of stay (LOS).ResultsModerate IFALD decreased from 32% to 20% (P = .005) in the guideline group. Time to achieve 50% and 100% energy from EN was decreased from medians of 8 to 5 and 28 to 21 days, respectively (P < .001). There was an overall decrease in PN use from 41 to 29 days (P = .002), CLABSI incidence from 25% to 5% (P < .001), and LOS from 70 to 53 days (P = .030). Once stratified by diagnosis, infants with NEC showed greatest improvement and reduction in IFALD from 67% to 42% (P = .045). With no difference in postoperative NEC (P = .464).ConclusionEarly standardized postoperative EN guidelines in intestinal‐surgery infants was associated with improved outcomes, including faster achievement of feeding goals and reduced IFALD severity, especially in infants with NEC.

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A contemporary analysis of parenteral nutrition–associated liver disease in surgical infants

Cited by 39 publications

References 24 publications

Complications Associated with Parenteral Nutrition in the Neonate

Complications Associated with Parenteral Nutrition in the Neonate

Parenteral Nutrition-Associated Liver Disease in Pediatric Patients: Strategies for Treatment and Prevention

Postoperative Feeding Guidelines Improve Outcomes in Surgical Infants

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