[Liver complications associated with short-term parenteral nutrition in children].
OBJECTIVE
Liver dysfunction (LD) with abnormalities in biochemical liver function tests is the most common metabolic complication of parenteral nutrition (PN). The aim of this study was to estimate the prevalence of LD in children receiving short-term PN and to identify risk factors.


METHODS
Data were gathered retrospectively during a 2-year period. Ninety-four children older than 28 days received PN (mean age 5.4 +/- 5.1 years). PN related LD was defined as when serum levels of one or more of the following liver function tests were increased: ALT > or = 80 IU/L, GGT > or = 120 IU/L and total bilirubin > or = 1.8 mumol/L. Children with previous liver disease were excluded (n = 17), as well as those with incomplete data (n = 16).


RESULTS
LD was present in 33 children (54%). The incidence rate was 5.8 cases/100 patient days of PN. It started 9.8 +/- 6.9 days after beginning PN. The nadir appeared during the second week of PN. The following variables did not appear to significantly influence the presence of PN: age, gender, nutritional status, PN caloric load or composition and underlying disease. Length of PN (9.6 +/- 4.4 vs 19.5 +/- 10.5 days; p < 0.001) and presence of sepsis (21% vs 55%, p = 0.014) were the only variables associated with LD. It was not necessary to discontinue PN because of LD in any case.


CONCLUSIONS
Early LD is present in more than 50% of our children on PN. In preventing LD we should try to avoid infection and to reduce the time on PN.
Moreno Villares
J M
JM
Unidad de Nutrición Clínica, Hospital Doce de Octubre, Madrid.
Gomis Muñoz
P
P
Galiano Segovia
M J
MJ
Valero Zanuy
M A
MA
Serrano Garrote
O
O
León Sanz
M
M
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000209:etiology*; D008297:Male; D019370:Observation; D010288:Parenteral Nutrition / Q000009:adverse effects*; D012189:Retrospective Studies; D013997:Time Factors
Complicaciones hepáticas asociadas a nutrición parenteral de corta duración en niños.