Parenteral nutrition—Related cholestasis in postsurgical neonates: Multivariate analysis of rick factors

Beath, S. V.; Davies, P.H. O'Connor; Papadopoulou, Argyro; Khan, Adam; Buick, R.G.; Corkery, J.J.; Gornall, P.; Booth, I W

doi:10.1016/s0022-3468(96)90507-2

Cited by 234 publications

(193 citation statements)

References 11 publications

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“…In our study, the incidence of septic episodes was similar to the other studies: 1.1 versus 0.4-1.5 septicemia/child/year of TPN in the previously published data (Colomb et al, 1992;Beath et al, 1996). Only 10% of our patients never had a catheter-related infection.…”

Section: Discussionsupporting

confidence: 92%

“…Only 10% of our patients never had a catheter-related infection. Negativecoagulase Staphylococcus was the main pathogen responsible for infection (43%), which is also in accordance with previous studies (Beath et al, 1996;Hermans et al, 2007).…”

Section: Discussionsupporting

confidence: 92%

“…Interestingly, risk factors were different depending on the kind of complication (Table 4). For biochemical impairment as reflected by abnormal liver biochemistries, we confirmed some risk factors previously described, such as a young age of TPN initiation, a long duration of TPN, a higher rate of catheterrelated infections, a higher volume and energy content of TPN, and a high glucose rate in TPN (expressed as absolute intake g/kg/d or as in relative amount of % caloric intake) (Candusso et al, 1995;Puntis, 1995;Beath et al, 1996;Kelly, 1998;Quiros-Tejeira et al, 2004;Kumpf, 2006). Surprisingly, the lipid rate in TPN was not statistically significantly related to biochemical abnormalities as previously described (Cavicchi et al, 2000;Kaufman et al, 2003;Kumpf, 2006;Diamanti et al, 2007;Hermans et al, 2007).…”

Section: Discussionsupporting

confidence: 84%

“…The duration of home TPN in our cohort was especially important; it was almost double the duration of previous pediatric studies (Colomb et al, 1992Beath et al, 1996;Diamanti et al, 2007, Fitzgibbons et al, 2010. We decided to include only children with more than 2 years of home TPN, which correspond to the theoretical duration of intestinal adaptation.…”

Section: Discussionmentioning

confidence: 99%

“…However, the lack of an accurate and standardized histological classification is an obstacle to compare studies. Many risk factors of PNALD have been identified (Ito and Shils, 1991;Beath et al, 1996;Colomb et al, 2000;Fitzgibbons et al, 2010). However, in children, data are fewer than in large adult cohorts and risk factors may be different.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of liver complications in children receiving long-term parenteral nutrition

et al. 2011

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Background/Objectives: The hepatic prognosis of long-term home total parenteral nutrition (TPN)-dependent children is poorly documented. The objective was to study outcome data in home TPN-dependent children and to describe precisely their liver biopsies in the attempt to analyze risk factors for biochemical and histological hepatic abnormalities. Subjects/Methods: Medical records of 42 children receiving home TPN for more than 2 years between January 1998 and December 2007 in a single approved home total parenteral center were reviewed. Hepatic biochemical abnormalities were analyzed. Hepatic biopsies were classified by two independent pathologists. Results: Duration of TPN was 7.9 ± 0.8 years (mean ± s.e.m.), with an average age at onset of 1.5 ± 0.5 years. A total of 24 patients (57%) developed biochemical liver abnormalities in an average of 2.9±0.4 years after starting TPN. Risk factors for biochemical abnormalities were younger age at TPN commencement, longer duration of TPN, higher rate of catheter-related infections and higher volume and energy content of TPN. Liver biopsies were carried out in 43% of patients (mean age 3.2±0.9 years). Almost all patients had fibrosis (94%). Risk factors were dependent on each histological abnormality: fibrosis was significantly associated with a shorter length of bowel and a longer duration of TPN; cholestasis correlated with a lower percentage of total parenteral energy intake due to lipids; and steatosis had no risk factor identified. Conclusion: Our study reports a high rate of histological liver abnormalities and analyzes risk factors in children who underwent very long-term home TPN.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%