Prevention of liver failure in parenteral nutrition-dependent children with short bowel syndrome

摘要: Abstract Progressive liver failure in parenteral nutrition (PN)-dependent children with short bowel syndrome carries significant morbidity and mortality. The authors retrospectively reviewed 47 consecutive patients diagnosed from October 1985 through 1995. All were treated according to a protocol designed promote intestinal motility discourage bacterial translocation. Elements of the included use taurine, vigilant prevention aggressive treatment sepsis, meticulous catheter care, early PN cycling, appropriate enteral feeding, measures inhibit gastrointestinal translocation, especially gram-negative rods. Complete blood counts serum function studies complied both clinic visits hospital admissions for each patient every 3 6 months while they on PN. Three lost follow-up after had moved out state. length time ranged 9.4 years an average 2.2 years. Elevated aspartate aminotransferase (AST), alanine (ALT), glutamyltransferase (GGT) present 82%, 66%, 84% patients, respectively. Alkaline phosphatase was elevated 58% patients. Eight (18%) are still PN, 31 (70%) have been weaned off Five died (11%). (7%) developed cholecystitis requiring cholecystectomy. No progressive failure. These results suggest that PN-related may be prevented most syndrome. Specific prevent cholestatic jaundice need further investigation.