Treatment of parenteral nutrition-associated liver disease: the role of lipid emulsions.

Abstract

Parenteral nutrition is a life-saving therapy for infants with intestinal failure. However, long-term parenteral nutrition carries the risk of progressive liver disease. Substantial data has implicated components of parenteral soybean oil in the pathogenesis of parenteral nutrition-associated liver disease (PNALD). Elevated serum concentrations of phytosterols, an abundance of omega-6 polyunsaturated fatty acids, and a relative paucity of α-tocopherol have been associated with the risk of cholestasis and hepatic injury observed in PNALD. Currently available treatment strategies include the reduction of the dose of administered parenteral soybean oil and/or the replacement of parenteral soybean oil with alternative parenteral lipid emulsions. The purpose of this review is to provide an overview of the pathogenetic mechanisms associated with the development of PNALD and the data evaluating currently available treatment strategies.

• Authors: Prathima Nandivada, Sarah J Carlson, Melissa I Chang, Eileen Cowan, Kathleen M Gura, Mark Puder
• Journal: Advances in nutrition (Bethesda, Md.) (Adv Nutr) Vol. 4 Issue 6 Pg. 711-7 (Nov 2013) ISSN: 2156-5376 [Electronic] United States
• PMID: 24228202 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Dietary Fats
• Fat Emulsions, Intravenous
• Fatty Acids, Omega-6
• Phytosterols
• Soybean Oil
• alpha-Tocopherol

Topics

• Cholestasis (etiology)
• Dietary Fats (adverse effects, therapeutic use)
• Fat Emulsions, Intravenous (adverse effects, therapeutic use)
• Fatty Acids, Omega-6 (adverse effects)
• Humans
• Intestinal Diseases (therapy)
• Liver (drug effects, pathology)
• Liver Diseases (etiology, pathology, therapy)
• Parenteral Nutrition (adverse effects)
• Phytosterols (adverse effects, blood)
• Soybean Oil (adverse effects, therapeutic use)
• alpha-Tocopherol (administration & dosage)