Effects of cyclic parenteral nutrition on parenteral nutrition-associated cholestasis in newborns
- 주제(키워드) newborn , neonatal intensive care units , cholestasis , cyclic parenteral nutrition
- 주제(기타) Nutrition & Dietetics
- 설명문(일반) [Bae, Hye Jung; Gwak, Hye Sun] Ewha Womans Univ, Coll Pharm, 52 Ewhayeodae Gil, Seoul 03760, South Korea; [Bae, Hye Jung; Gwak, Hye Sun] Ewha Womans Univ, Div Life & Pharmaceut Sci, 52 Ewhayeodae Gil, Seoul 03760, South Korea; [Bae, Hye Jung; Cho, Yoon Sook] Seoul Natl Univ Hosp, Dept Pharm, Seoul, South Korea; [Shin, Seung Han; Kim, Ee-Kyung; Kim, Han-Suk] Seoul Natl Univ, Dept Pediat, Coll Med, Seoul, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 H E C PRESS, HEALTHY EATING CLUB PTY LTD
- 발행년도 2019
- URI http://www.dcollection.net/handler/ewha/000000160004
- 본문언어 영어
- Published As http://dx.doi.org/10.6133/apjcn.201903_28(1).0007
- PubMed https://pubmed.ncbi.nlm.nih.gov/30896413
초록/요약
Background and Objectives: Parenteral nutrition (PN) is one of the main nutritional methods used in newborns; however, long-term PN may induce PN-associated cholestasis (PNAC). This study aims to evaluate the effect of cyclic PN in the prevention and improvement of PNAC in newborns requiring long-term PN. Methods and Study Design: A retrospective cohort study was conducted on patients admitted at the Seoul National University Children's Hospital neonatal intensive care unit between October 2010 and September 2015 and referred to the nutrition support team with total parenteral nutrition for more than 14 days. The primary outcome was the incidence of PNAC. The incidence of hypoglycemia, changes in direct bilirubin (DB) concentrations, and length of hospital stay were investigated. Results: A total of 124 patients were observed in this study. Among these, 100 patients received continuous PN, whereas 24 patients received both continuous and cyclic PN. PNAC occurred in 31.5% (39/124) of study population. The incidence rates of PNAC were 27.4% during continuous PN period and 20.8% during cyclic PN period. Cyclic PN was an independent factor that significantly decreased PNAC incidence (OR=0.154; 95% CI, 0.045-0.529, p=0.003). DB concentrations significantly decreased (p=0.049) with therapeutic cyclic PN, but remained normal with prophylactic cyclic PN. No significant difference in hypoglycemia incidence and length of hospital stay was observed in both continuous PN and continuous to cyclic PN groups. Conclusions: Cyclic PN could be effective in the prevention and improvement of PNAC and also safe in terms of hypoglycemia in newborns.
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