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[Hepatic complications in parenteral nutrition]
1Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel.
Zeitschrift Fur Gastroenterologie
|January 1, 1996
Summary
Parenteral nutrition can cause liver complications like steatosis and cholestasis in 15% of patients. Strategies to prevent these include enteral nutrition and increased fat supply.
Area of Science:
- Hepatology
- Clinical Nutrition
- Gastroenterology
Context:
- Parenteral nutrition (PN) is associated with significant hepatic complications in approximately 15% of patients.
- These complications manifest as steatosis, cholestasis, sludge, and gallstone formation.
- Risk factors include PN duration, high carbohydrate/low fat formulations, and extensive intestinal resection.
Purpose:
- To review the characteristics and potential preventative strategies for hepatic complications associated with parenteral nutrition.
- To highlight patient populations at higher risk for PN-induced liver injury.
- To discuss current understanding and future directions in managing PN-related hepatotoxicity.
Summary:
- Hepatic complications during parenteral nutrition (PN) affect about 15% of patients, presenting as steatosis, cholestasis, sludge, and gallstones.
- Complication rates increase with PN duration (>1-2 weeks), carbohydrate-rich/low-fat PN, and in patients with extensive intestinal resections.
- High-risk groups include neonates, children, IBD patients, post-ileum resection, and those with hepatic malignancies.
Impact:
- Identifies key risk factors and clinical presentations of parenteral nutrition-associated liver injury (PNALI).
- Suggests potential therapeutic and preventative strategies, including enteral nutrition, increased lipid emulsion, cyclic PN, and nutrient supplementation.
- Underscores the need for further research into the pathophysiology of PNALI to optimize patient outcomes.