BACKGROUND: In children who depend on long-term parenteral nutrition (PN), liver disease is a major complication that may lead to end-stage liver failure requiring liver transplantation. METHODS: This retrospective study investigated the influence of lipid emulsions on cholestasis onset in children receiving long-term total parenteral nutrition (TPN) with lipids. Ten children who presented with a total of 23 episodes of cholestasis, associated in 13 cases with thrombocytopenia, were studied. RESULTS: Changes in the lipid delivery preceded these complications in more than half the cases. The temporary decrease in lipid administration led to normalization of bilirubin in 17 episodes. CONCLUSIONS: These data suggest that lipid supply is one of the risk factors for PN-associated cholestasis. The link between cholestasis and the reticuloendothelial system overload needs to be better understood. Prevention of cholestasis might include the decrease in the lipid load. When cholestasis occurs, lipid supply should be temporarily stopped, especially in the case of associated thrombocytopenia.
BACKGROUND: In children who depend on long-term parenteral nutrition (PN), liver disease is a major complication that may lead to end-stage liver failure requiring liver transplantation. METHODS: This retrospective study investigated the influence of lipid emulsions on cholestasis onset in children receiving long-term total parenteral nutrition (TPN) with lipids. Ten children who presented with a total of 23 episodes of cholestasis, associated in 13 cases with thrombocytopenia, were studied. RESULTS: Changes in the lipid delivery preceded these complications in more than half the cases. The temporary decrease in lipid administration led to normalization of bilirubin in 17 episodes. CONCLUSIONS: These data suggest that lipid supply is one of the risk factors for PN-associated cholestasis. The link between cholestasis and the reticuloendothelial system overload needs to be better understood. Prevention of cholestasis might include the decrease in the lipid load. When cholestasis occurs, lipid supply should be temporarily stopped, especially in the case of associated thrombocytopenia.
Authors: Lee Call; Tiffany Molina; Barbara Stoll; Greg Guthrie; Shaji Chacko; Jogchum Plat; Jason Robinson; Sen Lin; Caitlin Vonderohe; Mahmoud Mohammad; Dennis Kunichoff; Stephanie Cruz; Patricio Lau; Muralidhar Premkumar; Jon Nielsen; Zhengfeng Fang; Oluyinka Olutoye; Thomas Thymann; Robert Britton; Per Sangild; Douglas Burrin Journal: J Lipid Res Date: 2020-04-29 Impact factor: 5.922
Authors: Mark Puder; Clarissa Valim; Jonathan A Meisel; Hau D Le; Vincent E de Meijer; Elizabeth M Robinson; Jing Zhou; Christopher Duggan; Kathleen M Gura Journal: Ann Surg Date: 2009-09 Impact factor: 12.969
Authors: Mathias Plauth; William Bernal; Srinivasan Dasarathy; Manuela Merli; Lindsay D Plank; Tatjana Schütz; Stephan C Bischoff Journal: Clin Nutr Date: 2019-01-16 Impact factor: 7.324