Pediatric Intestinal Failure-Associated Liver Disease Is Reversed With 6 Months of Intravenous Fish Oil
Pediatric Intestinal Failure-Associated Liver Disease Is Reversed With 6 Months of Intravenous Fish Oil
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DOI：
10.1177/0148607113495416
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发表时间：
2014-08-01
影响因子：
3.4
通讯作者：
Venick, Robert S.
中科院分区：
文献类型：
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作者：
Calkins, Kara L.;Dunn, James C. Y.;Venick, Robert S.
背景：研究表明，当静脉注射(IV)大豆油(SO)被鱼油(FO)取代时，直接高胆红素血症更有可能得到缓解。FO的必要期限尚未确定。这项研究试图确定24周的FO是否是治疗肠衰竭相关性肝病(IFALD)的有效和安全的治疗方法。材料和方法：这是一项临床试验，研究对象为2周至18岁的IFALD患儿。在10例接受肠外营养(PN)的患者中，用FO(1g/kg/d)取代了SO。将患者与接受SO治疗的20名历史对照组进行比较。因此，初级医疗队以不同的剂量开出了两组的处方。主要结果是胆汁淤积逆转的时间。次要结果是死亡、移植和完全肠道喂养。安全性测量包括生长、必需脂肪酸缺乏和评估出血风险的实验室标记物。结果：Kaplan-Meier法估计FO组75%的胆汁淤积在17周内消退，而SO组仅6%(P
Background: Studies have suggested that when intravenous (IV) soybean oil (SO) is replaced with fish oil (FO), direct hyperbilirubinemia is more likely to resolve. The necessary duration of FO has not been established. This study seeks to determine if 24 weeks of FO is an effective and safe therapy for intestinal failure-associated liver disease (IFALD). Materials and Methods: This is a clinical trial using patients with IFALD between the ages of 2 weeks and 18 years. SO was replaced with FO (1 g/kg/d) in 10 patients who were receiving most of their calories from parenteral nutrition (PN). Patients were compared with 20 historic controls receiving SO. SO for both groups was prescribed by the primary medical team at variable doses. The primary outcome was time to reversal of cholestasis. Secondary outcomes were death, transplant, and full enteral feeds. Safety measurements included growth, essential fatty acid deficiency, and laboratory markers to assess bleeding risk. Results: The Kaplan-Meier method estimated that 75% in the FO group would experience resolution of cholestasis by 17 weeks vs 6% in the SO group (P