Essential fatty acid deficiency in infants receiving parenteral nutrition

Postuma, Ray; Pease, P. W. B.; Watts, Rodney; Taylor, S. M.; McEVOY, Finbar A.

doi:10.1016/s0022-3468(78)80463-1

Cited by 29 publications

(23 citation statements)

References 14 publications

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“…However, a number of complications have resulted from the use of TPN. One of the most frequent is hepatic dysfunction (2), especially in infants (3). Liver dysfunction may be manifested by biochemical disturbances such as hyperammonemia (4), elevations in serum transaminases and alkaline phosphatase (5), cholestasis (3), and hepatomegaly, usually as a result of fatty infiltration (6).…”

Section: Introductionmentioning

confidence: 99%

Pathogenesis of hepatic steatosis in the parenterally fed rat.

Hall¹,

Grant²,

Ross³

et al. 1984

J. Clin. Invest.

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Section: Introductionmentioning

confidence: 99%

Pathogenesis of hepatic steatosis in the parenterally fed rat.

Hall¹,

Grant²,

Ross³

et al. 1984

J. Clin. Invest.

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“…Fifteen of our series of 94 patients who received TPN for over 14 consecutive days, developed cholestasis. This represents an incidence of 16%, a figure that compares favourably with an incidence of approximately 30% reported in the literature [4,7]. The pathogenesis of the TPNAC syndrome is considered to be multifactorial [12].…”

Section: Discussionmentioning

confidence: 61%

Total parenteral nutrition associated cholestasis: A predisposing factor for sepsis in surgical neonates?

et al. 1990

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Abstract.Of 496 neonates and infants less than i year of age admitted to the paediatric surgical intensive care unit (PSICU) over a 5 year period (1983)(1984)(1985)(1986)(1987), 94 required total parenteral nutrition (TPN) for more than 14 consecutive days, generally due to congenital anomalies of the digestive tract. Cholestasis occurred in 15 of them and 12 of these patients developed sepsis. In contrast, of the 79 patients on TPN that remained free from cholestasis, only 23 developed sepsis. The mortality rate for the TPNAC-group was substantially higher than for the group without TPNAC. It is suggested that development of TPNAC might lead to impairment of non-specific cellular immunity in neonates.

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“…Existem evidências adicionais que indicam que o recém-nascido prematuro tem uma capacidade pouco desenvolvida para síntese e secreção dos ácidos biliares 3,[15][16][17] . No estudo de Farrell e cols.…”

Section: Discussionunclassified

“…6 , em 1971, em prematuro cuja autópsia revelou a presença de cirrose e proliferação de dutos biliares com colestase. Nos mais de vinte anos que se seguiram, diversos autores confirmaram a associação entre a colestase e a NP [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] , bem como tentaram relacionar a CANP com características dos pacientes, das soluções de NP empregadas ou com circunstâncias em que ocorreu o suporte nutricional.…”

Section: Introductionunclassified

Parenteral nutrition related cholestasis: infection as the main risk factor

Carvalho

Silveira²

1995

J Pediatr (Rio J)

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Total parenteral nutrition-associated cholestasis (TPN-AC) is a clinical problem of special interest in neonates and in other age groups. This retrospective cohort study attempted to determine the incidence and the appearing time of cholestasis in Intensive Care Unit (ICU) patients beyond neonatal period, submitted to total parenteral nutrition (TPN) for more than five consecutive days, foccusing on the relation of TPN-AC and severe infection. Data on one hundred and thirteen patients, aged from one month to 14 years, collected over a period of ten years, were analyzed. All patients, followed up to the TPN stop or their death, were classified in two groups: with and without cholestasis. They were evaluated in relation to cholestasis potential risk factors, such as severe infection. Cholestasis was identified by a conjugated bilirrubin (DB) and total bilirrubin rate equal or superior to 40% and/or a DB equal or superior to 0.5 mg/dl during the TPN laboratory monitoring. Logistic regression analysis was used to control and to adjust for the cholestasis confusion factors. The incidence of cholestasis was 18%, but it was very important in patients younger than 6 months (26% vs 12%) (p=0.06), in patients that use TPN for more than 2 weeks (25% vs 8%) (p=0.01), as well as in patients with severe infection (24% vs 3%) (p=0.02). On the average cholestasis appeared 17.6 days after TPN inception, with a range of 5 to 35 days. Control of the simultaneous effect of age, TPN duration, and severe infection has shown that in patients with less than 6 months the relative risk was 2.6 (NS); in patients with TPN longer than 2 weeks it was 3.1 (p=0.02); and in patients with severe infection it was 7.4 (p=0.006). The results suggest that TPN-AC in children beyond neonatal period is a relatively frequent event (18%), and severe infection is the most important risk factor for cholestasis.J. pediatr. (Rio J.). 1995; 71(5):255-260: cholestasis, liver dysfunction, liver function tests, severe infection, total parenteral nutrition. ResumoA colestase associada à nutrição parenteral (CANP) é um problema clínico de especial interesse tanto no recém-nascido, quanto nas demais faixas etárias. O objetivo deste estudo de coorte (retrospectivo) foi o de determinar a incidência e o tempo de aparecimento de colestase em crianças com mais de um mês de idade hospitalizadas em Unidade de Tratamento Intensivo (UTI) Pediátrica e submetidas à nutrição parenteral (NP) por mais de cinco dias consecutivos, bem como, a relação entre a CANP e a infecção grave. Foram revisados 113 pacientes de UTI Pediátrica de hospital universitário de referência terciária, com idades de 1 mês a 14 anos, submetidos à NP por mais de 5 dias consecutivos, em um período de 10 anos. Os pacientes foram seguidos até a suspensão da NP ou até o óbito e classificados de acordo com o aparecimento de colestase. Também foram avaliados os potenciais fatores de risco para a colestase, entre os quais a infecção grave. A colestase foi caracterizada por uma relação da fração conjugada...

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Essential fatty acid deficiency in infants receiving parenteral nutrition

Cited by 29 publications

References 14 publications

Pathogenesis of hepatic steatosis in the parenterally fed rat.

Pathogenesis of hepatic steatosis in the parenterally fed rat.

Total parenteral nutrition associated cholestasis: A predisposing factor for sepsis in surgical neonates?

Parenteral nutrition related cholestasis: infection as the main risk factor

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