Published online July 3, 2006
PEDIATRICS Vol. 118 No. 1 July 2006, pp. e197-e201 (doi:10.1542/peds.2005-2662)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gura, K. M.
Right arrow Articles by Puder, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gura, K. M.
Right arrow Articles by Puder, M.
Related Collections
Right arrow Nutrition & Metabolism
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

EXPERIENCE AND REASON

Reversal of Parenteral Nutrition–Associated Liver Disease in Two Infants With Short Bowel Syndrome Using Parenteral Fish Oil: Implications for Future Management

Kathleen M. Gura, PharmDa,b, Christopher P. Duggan, MD, MPHb, Sharon B. Collier, MS, RDb, Russell W. Jennings, MDc, Judah Folkman, MDc, Bruce R. Bistrian, MDd and Mark Puder, MD, PhDc

a Department of Pharmacy
b Division of Gastroenterology/Nutrition
c Department of Surgery and the Vascular Biology Program, Children's Hospital Boston, Boston, Massachusetts
d Department of Medicine, Beth Israel Deaconess Hospital, Harvard Medical School, Boston, Massachusetts

Here we report the reversal of cholestasis in 2 infants with intestinal failure and parenteral nutrition–associated liver disease. Treatment involved the substitution of a conventional intravenous fat emulsion with one containing primarily omega-3 fatty acids. Biochemical tests of liver function improved significantly. One child was removed from the liver transplantation list because of improved hepatic function, and the second child had complete resolution of cholestasis while solely on parenteral nutrition. This suggests that fat emulsions made from fish oils may be an effective means of treating and preventing this often-fatal condition. A randomized, controlled trial is necessary to study the efficacy of this new approach to parenteral nutrition–associated liver disease.

Key Words: bilirubin • nutrition–infant • nutritional supplements • hepatic failure

Abbreviations: PN, parenteral nutrition • PNALD, parenteral nutrition–associated liver disease • PT, prothrombin time • CRP, C-reactive protein • AST, aspartate amino transferase • ALT, amino alanine transferase

Accepted Jan 19, 2006.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Arch. Dis. Child.Home page
A R Barclay, C E Paxton, P Gillett, D Hoole, J Livingstone, D Young, G Menon, F Munro, and D C Wilson
Regionally acquired intestinal failure data suggest an underestimate in national service requirements
Arch. Dis. Child., December 1, 2009; 94(12): 938 - 943.
[Abstract] [Full Text] [PDF]

Home page
 JPEN J Parenter Enteral NutrHome page
J. M. Woodward, A. N. Priest, K. G. Hollingsworth, and D. J. Lomas
Clinical Application of Magnetic Resonance Spectroscopy of the Liver in Patients Receiving Long-Term Parenteral Nutrition
JPEN J Parenter Enteral Nutr, November 1, 2009; 33(6): 669 - 676.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
T. M. Fishbein
Intestinal Transplantation
N. Engl. J. Med., September 3, 2009; 361(10): 998 - 1008.
[Full Text] [PDF]

Home page
 JPEN J Parenter Enteral NutrHome page
V. E. de Meijer, K. M. Gura, H. D. Le, J. A. Meisel, and M. Puder
Fish Oil-Based Lipid Emulsions Prevent and Reverse Parenteral Nutrition-Associated Liver Disease: The Boston Experience
JPEN J Parenter Enteral Nutr, September 1, 2009; 33(5): 541 - 547.
[Abstract] [Full Text] [PDF]

Home page
 Nutr Clin PractHome page
M. Hallikainen, L. Huikko, K. Kontra, M. Nissinen, V. Piironen, T. Miettinen, and H. Gylling
Effect of Parenteral Serum Plant Sterols on Liver Enzymes and Cholesterol Metabolism in a Patient With Short Bowel Syndrome
Nutr Clin Pract, August 1, 2008; 23(4): 429 - 435.
[Abstract] [Full Text] [PDF]

Home page
 Nutr Clin PractHome page
Y. A. Ching, K. Gura, B. Modi, and T. Jaksic
Pediatric Intestinal Failure: Nutrition, Pharmacologic, and Surgical Approaches
Nutr Clin Pract, December 1, 2007; 22(6): 653 - 663.
[Abstract] [Full Text] [PDF]

Home page
 Nutr Clin PractHome page
K. Gura, R. Strijbosch, S. Arnold, C. McPherson, and M. Puder
The Role of an Intravenous Fat Emulsion Composed of Fish Oil in a Parenteral Nutrition-Dependent Patient With Hypertriglyceridemia
Nutr Clin Pract, December 1, 2007; 22(6): 664 - 672.
[Abstract] [Full Text] [PDF]

Home page
 Nutr Clin PractHome page
C. J. Valentine and T. D. Puthoff
Enhancing Parenteral Nutrition Therapy for the Neonate
Nutr Clin Pract, April 1, 2007; 22(2): 183 - 193.
[Abstract] [Full Text] [PDF]

eLetters:

Read all eLetters

Fish versus Bear approach to treat total parenteral nutrition-associated cholestasis
Maria Immacolata Spagnuolo, et al.
Pediatrics Online, 20 Jul 2006 [Full text]