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ISSN 0035-0052 (Print)

2018, Number 3

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Rev Mex Pediatr 2018; 85 (3)

Cholestasis and parenteral nutrition in pediatrics

Anaya-Flórez MS, Barbosa-Cortés L

Language: Spanish
References: 33
Page: 106-111
PDF size: 241.62 Kb.


ABSTRACT

Total parenteral nutrition (TPN) is the contribution of macronutrients and micronutrients to cover the energy and growth requirements only through an intravenous route; it is prescribed in patients with gastrointestinal pathologies that prevent the sufficient oral or enteral supply of nutrients, and its administration requires considering the benefits vs. the risks. Among the factors related to the development of cholestasis are prolonged fasting, prematurity, low birth weight, sepsis, short bowel syndrome, necrotizing enterocolitis, some drugs, and the administration of TPN. Prolonged use of TPN has been associated with an increase in liver enzymes and complications such as cholelithiasis, steatosis and cholestasis. The incidence of cholestasis associated with parenteral nutrition (CANPT) is directly proportional to the duration of TPN. Other factors associated with CANPT are excessive caloric intake, type of solution and osmolarity. Recent evidence has shown that TPN solutions play a crucial role in the pathogenesis of CANPT. The present document includes a review of the main risk factors related to the development of cholestasis in the pediatric patient receiving total parenteral nutrition.


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