title: Rescue treatment of infants with intestinal failure and parenteral nutrition-associated cholestasis (PNAC) using a parenteral fish-oil-based lipid.
abstract: Four preterm infants with intestinal failure and severe parenteral nutrition-associated cholestasis (PNAC) received fish-oil-based parenteral lipid as rescue treatment in substitution for the standard soybean-based lipid preparation. The progression of liver disease was halted in 3 infants and they recovered with complete resolution of PNAC. The condition in two of these infants would almost certainly have progressed to end-stage hepatic failure if they had continued to receive long-term parenteral nutrition and <30% of total nutrition enterally. The remaining infant with residual inflamed bowel, protracted feeding intolerance and repeated episodes of sepsis did not respond. Our findings suggest that fish-oil-based parenteral lipid emulsion may contribute to effective treatment of PNAC in selected patients, which should be further evaluated in randomized controlled trials.
authors.affiliation: Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Level 6, Clinical Sciences Building, Shatin, N.T., Hong Kong.
authors.forename: Hon M
authors.initials: HM
authors.lastname: Cheung
authors.forename: Hugh S
authors.initials: HS
authors.lastname: Lam
authors.forename: Yuk H
authors.initials: YH
authors.lastname: Tam
authors.forename: Kim H
authors.initials: KH
authors.lastname: Lee
authors.forename: Pak C
authors.initials: PC
authors.lastname: Ng
mesh_terms: D002779:Cholestasis / Q000209:etiology / Q000628:therapy*; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D017809:Fatal Outcome; D005395:Fish Oils / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D007410:Intestinal Diseases / Q000628:therapy*; D008055:Lipids / Q000627:therapeutic use*; D017093:Liver Failure / Q000209:etiology / Q000517:prevention & control; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D008055:Lipids