Long-term parenteral nutrition and delayed establishment of enteral nutrition in extremely low birth weight infants with high enterostomy site is associated with prolonged cholestasis.

IF 1.5 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2024-12-20 DOI:10.1007/s00383-024-05946-z

Makoto Matsukubo, Koshiro Sugita, Mitsuru Muto, Keisuke Yano, Toshio Harumatsu, Tomonori Kurimoto, Masaya Kibe, Asataro Yara, Hiroshi Ohashi, Tsuyoshi Yamamoto, Eiji Hirakawa, Yoshiki Naito, Ayaka Nagano, Masakazu Murakami, Shun Onishi, Takafumi Kawano, Motofumi Torikai, Takuya Tokuhisa, Satoshi Ieiri

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引用次数: 0

Abstract

Purpose: Cholestatic liver damage is frequently observed in extremely low-birth-weight infants (ELBWIs) followed by enterostomy. We retrospectively investigated the factors related to liver damage.

Methods: ELBWIs who underwent enterostomy at our institution between January 2013 and December 2022 for gastrointestinal disease during the neonatal period were reviewed. Cases presenting with direct bilirubin > 2.0 mg/dl for > 1 month after enterostomy were designated as the prolonged cholestatic liver (p-CL) group and compared with cases without cholestatic liver damage, the (non-CL) group.

Results: Thirty-nine patients (21 in the p-CL group and 18 in the non-CL group) were included. Survival was significantly lower in the p-CL group (52.4% [11/21] vs. 88.9% [16/18]; p = 0.020). Significant differences were found in the birth weight (587.8 g vs. 698.0 g, p = 0.040) and small intestinal length to the enterostomy (47.6 cm vs. 72.8 cm, p = 0.004). Patients in the non-CL group started enteral feeding and reached > 100 ml/kg/day earlier than those in the p-CL group. The length of time with parenteral nutrition was an independent risk factor for prolonged cholestasis (p = 0.02).

Conclusion: The birth weight and stoma site level may affect time with PN and enteral feeding management, subsequently resulting in prolonged cholestatic liver damage in ELBWIs with high prematurity.

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肠造口部位高的极低出生体重儿的长期肠外营养和肠内营养的延迟建立与延长的胆汁淤积有关。

目的：在极低出生体重儿（ELBWIs）术后经常观察到胆汁淤积性肝损伤。我们回顾性调查了与肝损害相关的因素。方法：回顾2013年1月至2022年12月期间因新生儿期胃肠道疾病在我院行肠造口术的elbwi患者。将肠造口术后1个月出现直接胆红素> 2.0 mg/dl的病例定为延长型胆汁淤积肝（p-CL）组，与无胆汁淤积性肝损伤的病例比较为（非cl）组。结果：共纳入39例患者（p-CL组21例，非cl组18例）。p-CL组生存率显著降低（52.4% [11/21]vs. 88.9% [16/18]）；p = 0.020)。出生体重（587.8 g比698.0 g, p = 0.040）和小肠长度（47.6 cm比72.8 cm, p = 0.004）差异有统计学意义。非cl组患者开始肠内喂养，比p-CL组早达到100 ml/kg/d。肠外营养时间的长短是延长胆汁淤积的独立危险因素（p = 0.02）。结论：出生体重和造口部位水平可能影响高早产elbwi患者使用PN和肠内喂养管理的时间，从而导致胆汁淤积性肝损害延长。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor