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Published on: September 20, 2019
Pediatric Parenteral Nutrition-Associated Liver Disease
1Massachusetts General Hospital, Boston, Massachusetts. Jill C. Israelite, RD, LDN, CNSC®, CSP, has been in practice as an inpatient clinical nutrition specialist at Massachusetts General Hospital since 2005. She is board certified as a clinical nutrition support clinician and specialist in pediatric nutrition. Jill specializes in nutrition support, providing enteral and parenteral recommendations to the medical team for FTT, metabolic, short gut, trauma, CF and other patients in the pediatric intensive care unit and pediatric floors of MassGeneral Hospital for Children.
Abstract:
Pediatric parenteral nutrition-associated liver disease (PNALD) is typically defined as a decrease in bile flow that is independent of a mechanical obstruction and of any other underlying liver disease. It is most often seen in pediatric patients receiving parenteral nutrition support. Up to 50% to 66% of children receiving long-term parenteral nutrition are reported to be diagnosed with PNALD. The goal of treatment for PNALD is advancement to full enteral nutrition and elimination of dependence on parenteral nutrition support. Achieving this goal is not always possible, especially in patients with short bowel syndrome. The following review article highlights some of the current treatment strategies focused on prevention or correction of PNALD as noted in current American Society for Parenteral and Enteral Nutrition guidelines.
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