Cholestasis Induced by Total Parenteral Nutrition

Guglielmi, Francesco William; Regano, N.; Mazzuoli, S.; Fregnan, S.; Leogrande, G.; Guglielmi, A.; Merli, Manuela; Pironi, Loris; Penco, J M Morán; Francavilla, A.

doi:10.1016/j.cld.2007.11.004

Cited by 73 publications

(41 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They found that the IUGR group had a higher incidence of PN-induced cholestasis (56% versus 27%). Similiar studies have shown these findings and attributed them to metabolic and physiological changes to the hepatocytes secondary to uteroplacental insufficiency [15–17], specifically alteration in expression of glucose transporters [18] and higher susceptibility to infections [19]. Both of their groups had similar composition in PN nutrients.…”

Section: Discussionmentioning

confidence: 99%

“…Lack of enteral stimulation has been suggested to be a risk factor for developing PN-induced cholestasis by various mechanisms [19, 21–24]. First, it is thought that lack of enteral stimulation reduces growth factors secretions that would normally promote enterocyte maturations; second, there is also a decrease in secretion of gut hormones such as cholecystokinin, hence promoting bile stasis and decreasing enterohepatic circulation [15].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Parenteral Nutrition-Induced Cholestasis in Neonates: Where Does the Problem Lie?

Jolin-Dahel

Ferretti

Montiveros

et al. 2013

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Background. Parenteral nutrition (PN) is an effective method of nourishing the neonate who is unable to receive full enteral feeds. Cholestasis can be a complication of PN and can lead to severe liver damage. Aim. We describe our patient population and determine risk factors for developing PN cholestasis. Methods. Retrospective chart review of newborns admitted from January 2006 to May 2011 to the Neonatal Intensive Care Unit at our institution and received PN >14 days. Cholestasis was defined as serum conjugated bilirubin >50 μmol/L. Results. Eighty-seven newborns were included; 18 (20.7%) developed PN cholestasis. The most frequent surgical condition for both groups was gastroschisis (8/87; 9.2%). No significant differences were found between the cholestasis and control groups for the following parameters: birth weight, gestational age, intrauterine growth restriction, Apgar scores, and day of life at initiation of enteral feeds. Duration of PN in days and dosage of carbohydrates in g/kg/day were significantly higher in the cholestasis group than the control group. Conclusion. PN-related cholestasis presented in one-fifth of neonates receiving PN for more than two weeks. Longer duration of PN and higher dosage of carbohydrates were independent risk factors for the development of PN cholestasis in this population.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Parenteral Nutrition-Induced Cholestasis in Neonates: Where Does the Problem Lie?

Jolin-Dahel

Ferretti

Montiveros

et al. 2013

Gastroenterology Research and Practice

View full text Add to dashboard Cite

show abstract

“…According to the consensus, high cholesterol diets enlarge the size of liver bile acid pool; and the pool size is positively related to the degree of CYP7A1 inhibition [37, 38]. This phenomenon especially could be seen in the pre-term infants/minipigs [39–41], because of their immature livers functions to excrete the excess bile acids [1, 42]. …”

Section: Resultsmentioning

confidence: 99%

Determination of 7α-OH cholesterol by LC–MS/MS: Application in assessing the activity of CYP7A1 in cholestatic minipigs

Cui

Yin

Shatzer

et al. 2016

Journal of Chromatography B

View full text Add to dashboard Cite

An LC-MS/MS method was developed and validated to determine 7α-OH cholesterol in liver microsome. This method was convenient and fast with high specificity and sensitivity. Briefly, a gradient elution was performed on a Synergi polar-C18 column (50 × 4.6 mm i.d., 3 µm). The mobile phase (consisting of 0.1% HCOOH solution and acetonitrile) eluted in gradient at a flow rate of 1 ml/min. MS detection was operated on APCI (+) mode; the MRM transitions for 7α-OH cholesterol and D7-cholesterol (I.S.) were 385.1 -> 159.1 and 376.4 -> 266.3, respectively. The linear response range of 7α-OH cholesterol was covered from 1.563 to 100.0 ng/ml. All of the validation items meet the requirement of FDA guidance for bioanalytical method validation. This method was applied to enzymatic studies for determination of cholesterol 7alpha-hydroxylation activity catalyzed by CYP7A1 in the cholestatic minipigs liver microsomes.

show abstract

“…Parenteral nutrition-associated cholestasis usually improves after cessation of parenteral nutrition [56]. PNALD may be prevented or reversed if enteral feeding can be established.…”

Section: Route Of Nutritional Supportmentioning

confidence: 99%

“…If enteral nutrition is impossible, reducing the duration of daily parenteral nutrition or using cyclic infusions may be useful. The other preventive measures include maintaining the calories at less than 25 kcal/ kg/day and using lipid emulsions with long and mediumchain triglycerides or omega-9 monounsaturated fatty acids [56,57]. Moreover, metronidazole, ursodeoxycholic acid, and S-adenosylmethionine can be used.…”

Section: Route Of Nutritional Supportmentioning

confidence: 99%