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Ursodeoxycholic acid (UDCA) therapy in very-low-birth-weight infants with parenteral nutrition-associated cholestasis

Chien-Yi Chen1, Po-Nien Tsao, Huey-Ling Chen

  • 1Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan South Road, Taipei 100, Taiwan.

The Journal of Pediatrics
|September 3, 2004
PubMed

Insights

Ursodeoxycholic acid (UDCA) treatment shortened the duration and reduced peak direct bilirubin levels in very-low-birth-weight (VLBW) infants suffering from parenteral nutrition-associated cholestasis (PNAC). This suggests UDCA is beneficial for PNAC in VLBW infants.

Area of Science:

  • Neonatal medicine
  • Pediatric gastroenterology
  • Pharmacology

Background:

  • Parenteral nutrition-associated cholestasis (PNAC) is a serious complication in very-low-birth-weight (VLBW) infants.
  • Cholestasis in VLBW infants can lead to significant morbidity and mortality.
  • Effective therapeutic options for PNAC in VLBW infants are limited.

Purpose of the Study:

  • To evaluate the efficacy of ursodeoxycholic acid (UDCA) in treating PNAC in VLBW infants.
  • To compare the clinical outcomes of VLBW infants with PNAC treated with UDCA versus those who received no medical intervention.

Main Methods:

  • Retrospective study of VLBW infants diagnosed with PNAC at a tertiary referral center.
  • Patients were divided into a treatment group (received UDCA within 14 days of cholestasis onset) and a control group (no medical treatment).
  • Infants who underwent abdominal surgery were excluded from the analysis.

Main Results:

  • The UDCA treatment group (12 infants) showed a significantly shorter duration of cholestasis (62.8 days) compared to the control group (18 infants, 92.4 days; P=.006).
  • Peak serum direct bilirubin levels were significantly lower in infants treated with UDCA.
  • Demographic data and timing of cholestasis onset were comparable between groups, although a trend towards later onset was noted in the control group.

Conclusions:

  • Ursodeoxycholic acid (UDCA) administration can improve the clinical course of parenteral nutrition-associated cholestasis (PNAC) in very-low-birth-weight (VLBW) infants.
  • UDCA therapy offers a potential therapeutic benefit for VLBW infants experiencing PNAC.
  • Further research may explore optimal dosing and long-term outcomes of UDCA in this population.
Abstract

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