کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
4156013 | 1273764 | 2013 | 9 صفحه PDF | دانلود رایگان |

PurposeWe performed a pilot trial to compare reduced dose versus standard soybean lipid emulsion in neonates at risk for parenteral nutrition-associated liver disease.MethodsA prospective randomized controlled trial was performed (2009–2011) enrolling surgical patients ≥ 26 weeks' gestation anticipated to require > 50% of daily caloric intake from parenteral nutrition (PN) for at least 4 weeks. Randomization occurred into either reduced (1.0 g/kg/day) or standard (3 g/kg/day) groups. Co-primary outcomes for interpretation of the results were conjugated bilirubin and total bile acids. Additional outcomes included ALT, AST, GGT, alkaline phosphatase, growth, and essential fatty acid levels. Outcomes were compared between treatment groups using Wilcoxon rank sums tests.ResultsTwenty-eight patients (47% enrollment rate) were included in the study with an average treatment duration of 5.4 weeks. Groups had similar PN calories and protein intake throughout the study. Total increase from baseline was smaller in the reduced vs. standard group for conjugated bilirubin (p = 0.04) and total bile acids (p = 0.02). Weight z-score increased more in the standard group, and no patient experienced essential fatty acid deficiency.ConclusionMarkers of cholestasis rose at a slower rate using reduced lipid doses. This pilot study demonstrates feasibility and need for a larger study evaluating the effects of reduced lipids in patients at risk for developing parenteral nutrition-associated liver disease.
Journal: Journal of Pediatric Surgery - Volume 48, Issue 6, June 2013, Pages 1348–1356