PMID: 2506323Jul 1, 1989Paper

Decreased cholestasis with enteral instead of intravenous protein in the very low-birth-weight infant

Journal of Pediatric Gastroenterology and Nutrition
M R BrownD L Shapiro

Abstract

Thirty to 50% of very low-birth-weight infants have parenteral nutrition-associated cholestasis. To test the hypothesis that the incidence of cholestasis would be decreased if parenteral amino acids were avoided and protein given enterally, infants with a gestational age of less than 30 weeks were randomized to two groups. One group received amino acid-free parenteral nutrition and whey protein enterally with added premature infant formula. The control group received standard parenteral nutrition with amino acids and enteral premature formula. At the end of 3 weeks of parenteral nutrition, infants who had a direct serum bilirubin level of greater than 3 mg/dl were considered to have significant cholestasis. Twenty-nine infants required parenteral nutrition for 3 weeks, 17 in the whey group and 12 in the control group. No instances of significant cholestasis were observed in the whey group (0/17), whereas seven of 12 infants (58%) in the amino acid control group had cholestasis (p less than 0.001).

Citations

Feb 12, 2002·Pharmacotherapy·Imad F Btaiche, Nabil Khalidi
May 1, 2012·Clinics in Liver Disease·Asma Siddique, Kris V Kowdley
Nov 3, 2010·Journal of the American Dietetic Association·Catherine J KleinLouis Scavo
Oct 7, 2010·Early Human Development·Deirdre A Kelly
Nov 26, 2015·Clinics in Liver Disease·Sue V Beath, Deirdre A Kelly
Apr 9, 2001·Clinics in Liver Disease·I S SandhuG T Everson
Feb 25, 2003·Critical Care Nursing Clinics of North America·Frances Strodtbeck
Apr 30, 2003·Journal of Pediatric Gastroenterology and Nutrition·Robert J Shulman, Sarah Phillips

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