title: Total Parenteral Nutrition-Induced Cholestasis: Prevention and Management.
abstract: When cholestasis occurs in patients receiving total parenteral nutrition, it is the result of many pathogenic pathways converging on the hepatic acinus. The result may be a temporary rise in liver function tests. The resulting fibrosis, portal hypertension, and jaundice are hallmarks of type 3 intestinal-associated liver disease to which children are more susceptible than adults. The key to prevention is in identifying high-risk scenarios, meticulous monitoring, and personalized prescription of parenteral nutrition solutions combined with an active approach in reducing the impact of inflammatory events when they occur by prompt use of antibiotics and line locks.
authors.affiliation: The Liver Unit, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, West Midlands, B4 6NH, UK. Electronic address: Sue.beath@nhs.net.
authors.forename: Sue V
authors.initials: SV
authors.lastname: Beath
authors.affiliation: The Liver Unit, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, West Midlands, B4 6NH, UK.
authors.forename: Deirdre A
authors.initials: DA
authors.lastname: Kelly
mesh_terms: D000367:Age Factors; D000469:Alkaline Phosphatase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002779:Cholestasis / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy*; D042241:Early Diagnosis; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications* / Q000628:therapy; D041781:Jaundice, Obstructive / Q000209:etiology; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D010348:Patient Care Team; D010976:Platelet Count; D012307:Risk Factors; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D001663:Bilirubin
keywords: Cytokines; IFALD; Intravenous nutrition; Lipids; Liver disease; Microbiota; PNAC; PNALD