136 Growth and Lumenal Fatsolubilisation in Cholestatic Infants on Medium Chain Triglyceride (Mct)

Beath, S V; Johnson, Sally; Willis, Kerry; Kelly, D A; Booth, I W

doi:10.1097/00005176-199605000-00149

Cited by 9 publications

(6 citation statements)

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“…Still, it is difficult to specify the ideal dietary fat content and ratio of MCTs to LCTs. Limited data point to better fat solubilization and growth of cholestatic infants fed with 30 or 70% MCTs against a 50/50% mixture of MCTs/LCTs [25] . Essential fatty acid deficiency was described with the use of very high MCT content in the diet which was not sufficiently supplemented with PUFAs [23] .…”

Section: Lipids As Energy Sourcementioning

confidence: 99%

Nutritional Management of Cholestatic Syndromes in Childhood

Socha¹

2008

Ann Nestlé [Engl]

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Cholestatic liver disease causes severe risk of malnutrition which includes protein-energy malnutrition and specific nutritional deficiencies. The nutritional status can be assessed based on anthropometric measurements, which can be misleading because of ascitis and peripheral edema. Biochemical determinations of lipid-soluble vitamin status are important to evaluate requirements. Based on nutritional status assessment, nutritional therapy should be planned according to a well-defined schedule. The basic principle of nutritional management is to correct the nutritional status as well as to reduce the risk of nutritional deficiencies. Children with cholestasis usually need extra energy supply that can be obtained by increasing energy density of feeds or addition of glucose polymers and lipids. For catch-up growth, usually, protein intake should be increased. Lipid-soluble vitamin supplementation deserves special attention and it is not easy to correct poor vitamin E status. For some children, parenteral administration of vitamin K is needed. Since recently, a water-soluble vitamin E (d-α-tocopheryl polyethylene glycol 1000 succinate) given by oral route is used with a good therapeutic effect. As the liver disease progresses to liver failure in many chronic cholestatic diseases, nutritional therapy can often be regarded as ‘bridging’ for liver transplantation to improve prognosis. Thus, invasive nutritional support is justified in severe liver disease which usually includes nocturnal nasogastric tube feeding, or even parenteral nutrition.

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Section: Lipids As Energy Sourcementioning

confidence: 99%

Nutritional Management of Cholestatic Syndromes in Childhood

Socha¹

2008

Ann Nestlé [Engl]

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“…With interrupted or absent bile flow, infants with cholestasis will malabsorb fat. Some evidence suggests that increasing total fat intake in these patients might increase absorption, despite causing steatorrhea 2,19 . However, medium‐chain triglyceride (MCT) supplementation is commonly required to maintain growth.…”

Section: Chronic Liver Diseasementioning

confidence: 99%

“…Recent literature suggests that between 30% and 70% of fat should be provided as MCT 2,3 . Less than this will lead to continued malabsorption and growth failure; however, providing > 80% of total fat as MCT increases the risk of essential fatty acid (EFA) deficiency 19,20 …”

Section: Chronic Liver Diseasementioning

confidence: 99%

Feeding the child with liver disease: A review and practical clinical guide

Smart

Alex

Hardikar

2011

J of Gastro and Hepatol

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Nourishing children with liver disease is a challenging task; however, appropriate assessment and well-timed nutritional interventions are paramount for a good long-term outcome in these patients. An appropriate balance of macronutrients, micronutrients, and vitamins is important, as is the route of administration. This review aims to highlight the practical points in nutrition assessment and also provides a guide to the various nutritional interventions available for children with chronic liver disease.

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“…Sin embargo, es difícil especificar el contenido en grasa alimentaria y el cociente entre TCM y TCL ideales. Los datos limitados disponibles indican una mejor solubilización de las grasas y un mejor crecimiento de los lactantes colestáti-cos alimentados con el 30 ó el 70% de TCM frente a una mezcla del 50/50% de TCM/TCL [25] . Se describió la deficiencia de ácidos grasos esenciales con el empleo de un contenido en TCM muy elevado en la alimentación, que no había sido complementada suficientemente con AGPI [23] .…”

Section: Los Lípidos Como Fuente De Energíaunclassified

Tratamiento nutricional de los síndromes colestáticos en la infancia

Socha

2008

Ann Nestlé [Esp]

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La hepatopatía colestática causa un riesgo serio de desnutrición, que incluye la desnutrición de proteína y energía y las carencias nutricionales específicas. El estado nutricional puede evaluarse basándose en mediciones antropométricas, que pueden ser equívocas a causa de la ascitis y el edema periférico. Las determinaciones bioquímicas del estado de las vitaminas liposolubles son importantes para evaluar las necesidades de los niños. Basándose en la evaluación del estado nutricional, debe planificarse la terapia nutricional con arreglo a una pauta bien establecida. El principio básico del tratamiento nutricional consiste en corregir el estado nutricional, así como reducir el riesgo de carencias nutricionales. Los niños con colestasis precisan habitualmente un suministro extra de energía que puede obtenerse incrementando la densidad energética de los alimentos o añadiendo lípidos y polímeros de glucosa. Para recuperar el crecimiento, suele tener que incrementarse la ingestión de proteínas. El aporte complementario de vitaminas liposolubles merece atención especial y no es fácil corregir un estado carencial de vitamina E. En algunos niños es necesario administrar la vitamina K por vía parenteral. Desde hace poco tiempo se utiliza con buen efecto terapéutico una vitamina E hidrosoluble (d-α-tocoferil polietilenglicol 1.000 succinato), administrada por vía oral. Dado que la hepatopatía progresa hacia una insuficiencia hepática en numerosas enfermedades colestáticas crónicas, el tratamiento nutricional puede considerarse a menudo como una medida para ‘salir del paso’ a la espera del trasplante hepático para mejorar el pronóstico. En consecuencia, el apoyo nutricional invasivo está justificado en la hepatopatía grave y comprende habitualmente la alimentación nocturna por sonda nasogástrica o incluso la nutrición parenteral.

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136 Growth and Lumenal Fatsolubilisation in Cholestatic Infants on Medium Chain Triglyceride (Mct)

Cited by 9 publications

References 0 publications

Nutritional Management of Cholestatic Syndromes in Childhood

Nutritional Management of Cholestatic Syndromes in Childhood

Feeding the child with liver disease: A review and practical clinical guide

Tratamiento nutricional de los síndromes colestáticos en la infancia

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