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Total parenteral nutrition-related cholestasis in infants

R L Bell, G D Ferry, E O Smith

    JPEN. Journal of Parenteral and Enteral Nutrition
    |July 1, 1986
    PubMed

    Insights

    Total parenteral nutrition (TPN) is associated with cholestasis in infants. Risk factors include intracranial hemorrhage, patent ductus arteriosus, sepsis, and surgical gastrointestinal conditions, influencing TPN-related cholestasis development.

    Area of Science:

    • Neonatology
    • Pediatric Gastroenterology
    • Epidemiology

    Background:

    • Infants requiring total parenteral nutrition (TPN) are at risk for cholestasis.
    • Understanding risk factors for TPN-related cholestasis is crucial for infant health management.

    Purpose of the Study:

    • To estimate the incidence of TPN-associated cholestasis in neonates.
    • To identify specific risk factors contributing to TPN-related cholestasis in infants.

    Main Methods:

    • Epidemiological study design utilizing retrospective data.
    • Analysis of medical records from 624 infants aged ≤30 days receiving TPN.
    • Definition of TPN-related cholestasis: direct bilirubin ≥1.5 mg/dl post-TPN initiation.
    • Multiple logistic regression for risk factor assessment.

    Main Results:

    • The incidence of TPN-related cholestasis was 7.4% (46 out of 624 infants).
    • Significant risk factors identified: intracranial hemorrhage, patent ductus arteriosus, sepsis, and surgical gastrointestinal conditions.
    • Hypoxia-associated conditions (PDA, ICH) and TPN may trigger cholestasis; sepsis/GI surgery may cause cholestasis independently.

    Conclusions:

    • TPN-related cholestasis affects a notable proportion of infants.
    • Specific comorbidities significantly increase the risk of cholestasis in infants receiving TPN.
    • Distinct pathophysiological pathways may underlie cholestasis development in TPN-dependent infants based on underlying conditions.

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