Abstract | BACKGROUND: METHODS: Retrospective review of neonates admitted between 2007 and 2011 with a gastrointestinal condition necessitating ≥ 21 days of PN support. Neonates were divided into 2 groups based on the intravenous lipid emulsion dose: 1-g group (1 g/kg/d) and 2- to 3-g group (2-3 g/kg/d). The primary outcome measure was the incidence of cholestasis. RESULTS: Sixty-one patients met inclusion criteria (n = 29, 1-g group; n = 32, 2- to 3-g group). The 2 groups did not differ in any baseline characteristics other than associated comorbidities that were more common in the 2- to 3-g group. The duration of PN, the number of operative procedures and bloodstream infections, and enteral nutrition (EN) were similar between groups. The incidence of cholestasis was not different between groups (51.7%, 1-g group; 43.8%, 2- to 3-g group; P = .61), and there was no difference between groups in the time to cholestasis (32.6 ± 24.1 days, 1-g group; 27.7 ± 10.6 days, 2- to 3-g group; P = .48). Overall, 44.8% of patients with cholestasis were transitioned to full EN, and 55.2% were transitioned to a fish oil-based lipid emulsion after which the direct bilirubin normalized in all patients. CONCLUSION:
Lipid reduction to 1 g/kg/d does not prevent or delay the onset of cholestasis in neonates.
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Authors | Deepika Nehra, Erica M Fallon, Sarah J Carlson, Alexis K Potemkin, Nathanael D Hevelone, Paul D Mitchell, Kathleen M Gura, Mark Puder |
Journal | JPEN. Journal of parenteral and enteral nutrition
(JPEN J Parenter Enteral Nutr)
Vol. 37
Issue 4
Pg. 498-505
(Jul 2013)
ISSN: 1941-2444 [Electronic] United States |
PMID | 22767698
(Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Fat Emulsions, Intravenous
- Fish Oils
- Soybean Oil
- Bilirubin
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Topics |
- Bilirubin
(blood)
- Cholestasis
(blood, etiology, prevention & control)
- Enteral Nutrition
- Fat Emulsions, Intravenous
(administration & dosage, adverse effects)
- Female
- Fish Oils
(administration & dosage)
- Humans
- Infant, Newborn
- Male
- Parenteral Nutrition
(adverse effects, methods)
- Retrospective Studies
- Soybean Oil
(administration & dosage, adverse effects)
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