The Turkish Journal of Pediatrics 2014 , Vol 56 , Num 5
Composition of Parenteral Nutrition Solution Affects the Time of Occurrence But Not the Incidence of Cholestasis in Surgical Infants
Departments of 1Pediatric Surgery and 2Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Received: 27 January 2014, Revised: 5 June 2014, Accepted: 2 July 2014
Parenteral nutrition-associated cholestasis (PNAC) is one of the most important complications of parenteral nutrition (PN). This study was conducted to define the incidence, characteristics and precipitating factors of PNAC in infants treated with two different PN regimens in the pediatric surgery department.

The records of infants who received two different PN regimens during January 2000-May 2008 (Group 1) and June 2008-May 2012 (Group 2) were reviewed retrospectively. Patients with and without PNAC comprised the study (Groups 1a-2a) and control groups (Groups 1b-2b), respectively.

With Group 1 (n=109) and Group 2 (n=46) constituted as indicated, Group 1a (n=13), Group 1b (n=32), Group 2a (n=6) and Group 2b (n=8) were evaluated. The incidence of PNAC was 14.1% (n=22), and the type of PN regimen did not affect the incidence (14.6% vs. 13.0%, p=0.39). The duration of PN was longer in Group 1a than in Group 1b (34±37 vs. 13±10 days, p=0.01), and longer in Group 2a than in Group 1a or Group 2b (146±148 vs. 34±37 days, p=0.02, and 14.0±5.9 days, p=0.002). PNAC developed later in Group 2a than in Group 1a (42.0±24.6 vs. 9.0±8.3 day, p=0.02). The lipid dosage was higher in Group 1a than in Group 1b (3.5±0.7 vs. 3.45±0.54 g/ kg/day, p=0.001) or Group2a (2.2±0.4 g/kg/day, p=0.01). The lipid dosage was also higher in Group 2a than in Group 2b (p=0.001).

Two different regimens resulted in similar PNAC rates. The composition of nutrients in PN solution affects the time of occurrence but not the duration of PNAC. PNAC should be detected as early as possible and treated promptly. Keywords : cholestasis, infant, parenteral nutrition, surgery, hyperbilirubinemia, neonate.

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