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

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 choles...

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Main Authors: Kheira Jolin-Dahel, Emanuela Ferretti, Carolina Montiveros, Renee Grenon, Nick Barrowman, Carolina Jimenez-Rivera
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2013/163632
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author Kheira Jolin-Dahel
Emanuela Ferretti
Carolina Montiveros
Renee Grenon
Nick Barrowman
Carolina Jimenez-Rivera
author_facet Kheira Jolin-Dahel
Emanuela Ferretti
Carolina Montiveros
Renee Grenon
Nick Barrowman
Carolina Jimenez-Rivera
author_sort Kheira Jolin-Dahel
collection DOAJ
description 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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spelling doaj-art-f83a90388c724cfeba9d6e4b616ffcdf2025-08-20T03:25:35ZengWileyGastroenterology Research and Practice1687-61211687-630X2013-01-01201310.1155/2013/163632163632Parenteral Nutrition-Induced Cholestasis in Neonates: Where Does the Problem Lie?Kheira Jolin-Dahel0Emanuela Ferretti1Carolina Montiveros2Renee Grenon3Nick Barrowman4Carolina Jimenez-Rivera5University of Ottawa, Ottawa, ON, K1H 8L1, CanadaUniversity of Ottawa, Ottawa, ON, K1H 8L1, CanadaUniversity of Ottawa, Ottawa, ON, K1H 8L1, CanadaDepartment of Statistics, Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, CanadaDepartment of Statistics, Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, CanadaUniversity of Ottawa, Ottawa, ON, K1H 8L1, CanadaBackground. 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.http://dx.doi.org/10.1155/2013/163632
spellingShingle Kheira Jolin-Dahel
Emanuela Ferretti
Carolina Montiveros
Renee Grenon
Nick Barrowman
Carolina Jimenez-Rivera
Parenteral Nutrition-Induced Cholestasis in Neonates: Where Does the Problem Lie?
Gastroenterology Research and Practice
title Parenteral Nutrition-Induced Cholestasis in Neonates: Where Does the Problem Lie?
title_full Parenteral Nutrition-Induced Cholestasis in Neonates: Where Does the Problem Lie?
title_fullStr Parenteral Nutrition-Induced Cholestasis in Neonates: Where Does the Problem Lie?
title_full_unstemmed Parenteral Nutrition-Induced Cholestasis in Neonates: Where Does the Problem Lie?
title_short Parenteral Nutrition-Induced Cholestasis in Neonates: Where Does the Problem Lie?
title_sort parenteral nutrition induced cholestasis in neonates where does the problem lie
url http://dx.doi.org/10.1155/2013/163632
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