Abstract
Of the 221 infants admitted in 1976 weighing ≥2000 gm, 33% received TPN for periods ranging from 1 to 111 days. Of these infants receiving TPN 25% (16) developed direct hyperbilirubinemia (≥1.5 mg%) secondary to TPN cholestasis. The onset of direct hyperbilirubinemia occurred at a mean of 40 days but varied from the end of the 1st week to the 13th week of TPN, without any apparent time of peak incidence. The incidence of TPN cholestasis was 8.8% in infants receiving TPN for 10 days and increased progressively to 47% at 40 days. The highest incidence of direct hyperbilirubinemia was found in the very premature infant. The incidence in the <1000 gm group was 53%. The incidences in the 1000-1499 gm and 1500-2000 gm groups were 18% and 12% respectively. Comparing the means for birth weights, length of TPN, and protein intakes in the infants with and without elevated direct bilirubins revealed the following data:
It appears that very low birth weight infants are particularly susceptible to TPN cholestasis but this is probably due to the fact that they required TPN for longer periods of time. The length of TPN and the total amount of protein administered were the greatest risk factors in the production of TPN cholestasis.
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Beale, E., Nelson, R., Bucciarilli, R. et al. 396 TOTAL PARENTERAL NUTRITION (TPN) CHOLESTASIS IN PREMATURE INFANTS. Pediatr Res 12 (Suppl 4), 429 (1978). https://doi.org/10.1203/00006450-197804001-00401
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DOI: https://doi.org/10.1203/00006450-197804001-00401