Early central catheter infections may contribute to hepatic fibrosis in children receiving long-term parenteral nutrition.
J Pediatr Gastroenterol Nutr
; 44(4): 459-63, 2007 Apr.
Article
en En
| MEDLINE
| ID: mdl-17414144
ABSTRACT
BACKGROUND:
Bacterial infections in infants constitute a risk factor for parenteral nutrition (PN)-related cholestasis. The possible role of infections in the development of liver fibrosis, the most severe long-term complication, has yet to be documented. This study retrospectively compares the incidence of sepsis in children with and without severe liver fibrosis. PATIENTS ANDMETHODS:
Medical reports of 30 children in prolonged PN programs between March 1985 and March 2000 were reviewed. Starting at birth, the mean PN duration was 65 months (range, 8-150 months). According to the results of liver biopsy (LB), patients were split into 2 groups group A (n = 16) with severe liver fibrosis (ie, septal fibrosis involving >50% of portal fields or cirrhosis) and group B (n = 14) with normal hepatic architecture or mild fibrosis (<50% of portal fields).RESULTS:
Duration of PN at the time of LB was shorter in group A (30.5 months; range, 8-96 months) than in group B (105 months; range, 37-150 months; P < 0.001). In group A the incidence of sepsis was significantly higher than in group B (3.2 +/- 0.3/year vs 1.5 +/- 0.2/year) and the first infection occurred earlier (group A, 1 month [range, 1-2 months]; group B, 4 months [range, 1-19 months]). By contrast, both groups were similar in terms of pregnancy duration, birth weight, age of PN onset, underlying diseases, mode of PN delivery, and number of cholestasis episodes.CONCLUSIONS:
Incidence and early onset of infections may contribute to the development of liver fibrosis in cases of long-term PN. New strategies are required in prevention and treatment of infections in children receiving PN.
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Infecciones Bacterianas
/
Cateterismo Venoso Central
/
Nutrición Parenteral
/
Cirrosis Hepática
Tipo de estudio:
Risk_factors_studies
Límite:
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Año:
2007
Tipo del documento:
Article
País de afiliación:
Bélgica