Carsi-Bocanegra EE, Rafael-Alemán B, Michel-Quintero BY

Language: Spanish
References: 13
Page: 261-266
PDF size: 597.39 Kb.

ABSTRACT

Background: Neonatal cholestasis (NC) is an increase of conjugated bilirrubin for more than 2 mg/ dl or greater than 20% of total bilirrubin. Is multifactorial in etiology with Parenteral Nutrition (PN) as the major toxic cause. Incidence is about 30-40% and in infants less than 1000 g increases to 50%.
Objective: To know the prevalence of and causes for NC related to PN in prematures treated in a neonatal intensive care unit.
Material and methods: Descriptive and retrolective research carried out at Unidad de Cuidados Intensivos Neonatales from Centro Médico Nacional 20 de Noviembre (ISSSTE) in the period from December 2009 to November 2012. Babies less than 2 kg when born with NC of PN etiology were included. We analyzed gestational age, weight at born, Apgar score, PN, fasting days, serum conjugated bilirrubin and the enzymes ALT, AST, time for resolution, risk factors and final outcome.
Results: From the 245 preterm babies born, 170 received PN. 8 had cholestasis, with a prevalence of 6.9 for each 100 born. Fasting days average was 23.5 ± 14.1; the average days for cholestasis appearing, was at 16.5 ± 3.2 days of life. Maximum conjugated bilirrubin was 7.6 ± 3.6. Time for resolution was 42 ± 21.2 days. Average AST was 107.5 ± 37.5 and 71.4 ± 25.4 for ALT.
Conclusions: According to literature we found that fasting days, extremely premature, neonatal sepsis and delay in reaching an acceptable oral nutrition amount are the main causes for this illness.

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