Assessment of Nutritional Status of Postoperative Patients with Biliary Atresia.

Abstract

Some patients of biliary atresia (BA) suffer from chronic hepatic dysfunction and/or persistent jaundice. The adverse effects of chronic liver disease on nutrition and growth should be considered on BA patients. We studied 45 BA patients ranging in age from 0.5 to 38 years and divided them into 2 groups. Group A contains the patients whose total bilirubin > or = 2 mg/100 ml, and Group B contains the patients whose total bilirubin < 2 mg/100 ml. We measured height, weight, triceps skin fold (TSF), midarm circumference (MAC) and midarm muscle area (MAMA). Visceral protein kinetics was evaluated on the basis of serum albumin and prealbumin levels. Caloric and protein intake was calculated by collecting intake data for 3 days. The results of this study were; 1) The mean TSF in Group A (47th percentile) was not significantly different from that in Group B (53th percentile). 2) The mean MAMA was significantly lower (p < 0.01) in Group A (16.4th percentile) than in Group B (36.7th percentile) 3) The prealbumin level was significantly lower (p < 0.001) in Group A (mean 9.9 mg/100 ml) than in Group B (mean 18.8 mg/100 ml). The authors conclude that the evaluation of MAMA and prealbumin were very useful to characterize the low metabolic status of protein in the damaged liver. And repeated nutritional assessment was necessary to evaluate liver function and provide adequate nutrition in BA patients.

Biliary atresia: A transplant perspective

“…Diminishment of height and head circumference growth velocity is a late manifestation of poor nutritional status. Thus, a more accurate assessment of nutritional status in children with biliary atresia is dependent on more sensitive markers such as anthropometrics, including midarm muscle area and skinfold thickness 23, 24. Therefore, transplant assessment of a child with biliary atresia should include a comprehensive analysis of growth, permitting a more accurate appreciation of the child's clinical status.…”

Growth evaluation in infants with neonatal cholestasis

“…Large studies show that the results are good in about 1/3 of the cases, while 2/3 of the patients continue with jaundice (2) , which means reduced fat digestion. SHIGA et al (20) , conducted a study to evaluate the nutritional status of patients during the postoperative period of biliary atresia. They found that those patients whose total bilirubin levels were above 2 mg/100mL had smaller muscle area in the arms and lower prealbumin levels when compared to patients whose bilirubin levels were lower than 2 mg/100 mL.…”

Feeding practices in 6–24-month-old children with chronic cholestatic liver diseases: a mixed-method study

“…Previous studies revealed that the feeding practices were suboptimal, but these studies lacked detailed descriptions and analyses of dietary intake and had small sample sizes. In addition, these studies were conducted before the feeding guidelines for children with chronic cholestasis were published; thus, their conclusions were drawn through comparison to the RDA of normal children instead of cholestatic children [11,12]. Moreover, the reasons behind parents' feeding practices remain unclear, making it difficult to cost-effectively promote behavioral changes.…”