Parenteral nutrition-associated liver complications in children

被引:69
作者
Btaiche, IF [1 ]
Khalidi, N [1 ]
机构
[1] Univ Michigan Hlth Syst, Dept Pharm Serv, Ann Arbor, MI 48109 USA
来源
PHARMACOTHERAPY | 2002年 / 22卷 / 02期
关键词
D O I
10.1592/phco.22.3.188.33553
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Parenteral nutrition is a life-saving therapy for patients with intestinal failure. It may be associated with transient elevations of liver enzyme concentrations, which return to normal after parenteral nutrition is discontinued. Prolonged parenteral nutrition is associated with complications affecting the hepatobiliary system, such as cholelithiasis, cholestasis, and steatosis. The most common of these is parenteral nutrition-associated cholestasis (PNAC), which may occur in children and may progress to liver failure. The pathophysiology of PNAC is poorly understood, and the etiology is multifactorial. Risk factors include prematurity, long duration of parenteral nutrition, sepsis, lack of bowel motility, and short bowel syndrome. Possible etiologies include excessive caloric administration, parenteral nutrition components, and nutritional deficiencies. Several measures can be undertaken to prevent PNAC, such as avoiding overfeeding, providing a balanced source of energy, weaning parenteral nutrition, starting enteral feeding, and avoiding sepsis.
引用
收藏
页码:188 / 211
页数:24
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