Review of parenteral nutrition-associated liver disease

Żalikowska-Gardocka, Marta; Przybyłkowski, Adam

doi:10.5114/ceh.2019.95528

Cited by 19 publications

(24 citation statements)

References 85 publications

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“…Research on the effects of parenteral nutrition has focused on the possibility of liver dysfunction as well as an increase in liver enzymes [ 35 ]. This phenomenon is a potential result of cholestasis, which is caused by biliary obstruction or impaired secretion of bile [ 36 ]. On appearance, γ-glutamyl transpeptidase, alkaline phosphatase, and conjugated bilirubin levels are elevated.…”

Section: Discussionmentioning

confidence: 99%

Does Route of Full Feeding Affect Outcome among Ventilated Critically Ill COVID-19 Patients: A Prospective Observational Study

et al. 2021

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The outbreak of the new coronavirus strain SARS-CoV-2 (COVID-19) highlighted the need for appropriate feeding practices among critically ill patients admitted to the intensive care unit (ICU). This study aimed to describe feeding practices of intubated COVID-19 patients during their second week of hospitalization in the First Department of Critical Care Medicine, Evaggelismos General Hospital, and evaluate potential associations with all cause 30-day mortality, length of hospital stay, and duration of mechanical ventilation. We enrolled adult intubated COVID-19 patients admitted to the ICU between September 2020 and July 2021 and prospectively monitored until their hospital discharge. Of the 162 patients analyzed (52.8% men, 51.6% overweight/obese, mean age 63.2 ± 11.9 years), 27.2% of patients used parenteral nutrition, while the rest were fed enterally. By 30 days, 34.2% of the patients in the parenteral group had died compared to 32.7% of the patients in the enteral group (relative risk (RR) for the group receiving enteral nutrition = 0.97, 95% confidence interval = 0.88–1.06, p = 0.120). Those in the enteral group demonstrated a lower duration of hospital stay (RR = 0.91, 95% CI = 0.85-0.97, p = 0.036) as well as mechanical ventilation support (RR = 0.94, 95% CI = 0.89–0.99, p = 0.043). Enteral feeding during second week of ICU hospitalization may be associated with a shorter duration of hospitalization and stay in mechanical ventilation support among critically ill intubated patients with COVID-19.

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Section: Discussionmentioning

confidence: 99%

Does Route of Full Feeding Affect Outcome among Ventilated Critically Ill COVID-19 Patients: A Prospective Observational Study

et al. 2021

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“…Liver dysfunction is common in infant and adult patients receiving PN for both short-and long-term. Prolonged PN feeding can lead to PN associated liver disease (PNALD), fibrosis, steatosis, and eventually liver failure [99,100].…”

Section: Changes In Liver Function During Pnmentioning

confidence: 99%

Parenteral Nutrition Modeling and Research Advances

Kumari¹,

Pierre²

2022

Preclinical Animal Modeling in Medicine

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Parenteral nutrition (PN) provides nutritional support intravenously to individuals who have gastrointestinal (GI) failure or contraindication to enteral feeding. Since the initial development of PN, researchers have developed specialized formulas with complete macronutrients, micronutrients, vitamins, minerals, and electrolytes to support patients’ metabolic needs. These formulas prevent malnutrition and optimize patient health, especially under long-term feeding circumstances. Although PN is commonly used and essential in preterm and malnourished patients, complications associated with PN feeding include gastrointestinal defects, infection, and other metabolic abnormalities such as liver injury and brain related disorders. In this chapter, we highlight an overview of PN and its association with abnormalities of microbiome composition as well as with gastrointestinal (GI), immune, hepatic, and neuronal disfunction. Within the gut, PN influences the number and composition of gut-associated lymphoid tissue (GALT) cells, altering adaptive immune responses. PN also modulates intestinal epithelium cell turnover, secretions, and gut barrier function, as well as the composition of the intestinal microbiome leading to changes in gut permeability. Collectively, these changes result in increased susceptibility to infection and injury. Here, we highlight animal models used to examine parenteral nutrition, changes that occur to the major organ systems, and recent advancement in using enteric nervous system (ENS) neuropeptides or microbially derived products during PN, which may improve GI, immune cell, hepatic, and neuronal function.

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“…PNALD is defined as a heterogeneous injury of the liver, characterized by cholestasis, steatosis, and, eventually, fibrosis and cirrhosis [ 77 , 123 ]. Several animal experiments in piglet, guinea pig, and rat models have demonstrated that a continuous infusion of oxidized TPN solution for some days affects hepatobiliary function.…”

Section: In Vivo Impact Of Oxidized Tpn After Infusionmentioning

confidence: 99%

Parenteral Nutrition and Oxidant Load in Neonates

2021

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Neonates with preterm, gastrointestinal dysfunction and very low birth weights are often intolerant to oral feeding. In such infants, the provision of nutrients via parenteral nutrition (PN) becomes necessary for short-term survival, as well as long-term health. However, the elemental nutrients in PN can be a major source of oxidants due to interactions between nutrients, imbalances of anti- and pro-oxidants, and environmental conditions. Moreover, neonates fed PN are at greater risk of oxidative stress, not only from dietary sources, but also because of immature antioxidant defences. Various interventions can lower the oxidant load in PN, including the supplementation of PN with antioxidant vitamins, glutathione, additional arginine and additional cysteine; reduced levels of pro-oxidant nutrients such as iron; protection from light and oxygen; and proper storage temperature. This narrative review of published data provides insight to oxidant molecules generated in PN, nutrient sources of oxidants, and measures to minimize oxidant levels.

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Review of parenteral nutrition-associated liver disease

Cited by 19 publications

References 85 publications

Does Route of Full Feeding Affect Outcome among Ventilated Critically Ill COVID-19 Patients: A Prospective Observational Study

Does Route of Full Feeding Affect Outcome among Ventilated Critically Ill COVID-19 Patients: A Prospective Observational Study

Parenteral Nutrition Modeling and Research Advances

Parenteral Nutrition and Oxidant Load in Neonates

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