Rescue treatment of infants with intestinal failure and parenteral nutrition-associated cholestasis (PNAC) using a parenteral fish-oil-based lipid.
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.
Cheung
Hon M
HM
Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Level 6, Clinical Sciences Building, Shatin, N.T., Hong Kong.
Lam
Hugh S
HS
Tam
Yuk H
YH
Lee
Kim H
KH
Ng
Pak C
PC
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
D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D008055:Lipids