Lipid Intolerance in Newborns Is Associated With Hepatic Dysfunction but Not Infection

Toce, Suzanne S.; Keenan, William

doi:10.1001/archpedi.1995.02170240067010

Cited by 35 publications

(26 citation statements)

References 35 publications

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“…Specifically, it has been recommended that lipid concentration should not exceed 2.5 g/kg/day [32] and that dosage higher than 1 g/kg/day correlated with liver damage [33, 34]. Although excess lipid has been shown to accumulate in Kupffer cells [35, 36], there is no evidence that it directly causes cholestasis and if so, the mechanism is still not well understood [13, 27, 37–39]. …”

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

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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.

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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

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“…Elevation of serum triglycerides during sepsis293 and increased serum oxygen-derived free radicals associated with infusions of lipid have prompted some clinicians to withhold or decrease intralipid infusions. A recent study showed concurrent administration of intralipids in neonates with infection is not associated with hypertriglyceridemia in the absence of liver dysfunction or fetal growth restriction294. It is suggested that intralipid infusions during sepsis or septic shock in neonates be accompanied by careful monitoring of serum triglycerides to avoid hypertriglyceridemia.…”

Section: Treatment Of Sepsis and Septic Shockmentioning

confidence: 99%

Pathophysiology and Treatment of Septic Shock in Neonates

Wynn

Wong

2010

Clinics in Perinatology

204

153

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Neonatal septic shock is a devastating condition associated with high morbidity and mortality. Definitions for the sepsis continuum and treatment algorithms specific for premature neonates are needed to improve studies of septic shock and assess benefit from clinical interventions. Unique features of the immature immune system and pathophysiologic responses to sepsis, particularly those of extremely preterm infants, necessitate that clinical trials consider them as a separate group. Keen clinical suspicion and knowledge of risk factors will help to identify those neonates at greatest risk for development of septic shock. Genomic and proteomic approaches, particularly those that use very small sample volumes, will increase our understanding of the pathophysiology and direct the development of novel agents for prevention and treatment of severe sepsis and shock in the neonate. Although at present antimicrobial therapy and supportive care remain the foundation of treatment, in the future immunomodulatory agents are likely to improve outcomes for this vulnerable population.

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“…17 In critically ill neonates, hypertriglyceridemia from lipid infusions has been associated with hepatic dysfunction and growth retardation. 18 Most recently, the infusion of coarse lipid emulsions failing USP chapter 729 limits in critically ill premature infants produced hypertriglyceridemia compared with those receiving the same emulsion that formerly met these globule-size standards. 19 These factors would also suggest that pharmaceutical equivalence is clinically important and that coarse dispersions are probably not bioequivalent in this patient population.…”

Section: Lipid Globule-size Profiles Of High-osmolarity Total Nutrienmentioning

confidence: 99%

Lipid globule size in total nutrient admixtures prepared in three-chamber plastic bags

Driscoll

Thoma

Franke

et al. 2009

American Journal of Health-System Pharmacy

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Lipid Intolerance in Newborns Is Associated With Hepatic Dysfunction but Not Infection

Cited by 35 publications

References 35 publications

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

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

Pathophysiology and Treatment of Septic Shock in Neonates

Lipid globule size in total nutrient admixtures prepared in three-chamber plastic bags

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