Comparison of parenteral nutrition cycled and continuous in the presentation of cholestasis in preterm infants

Author: 
Aldo Castillo Rodríguez, Luis Fernando Castro Puig and Noé Belmar Díaz Gómez

Introduction: Prematurity is one of the pathologies that lead to greater morbidity and mortality, being the first cause of death in newborn patients (up to 28 days of life) and the second cause in children under 5 years of age. One of the most used strategies to improve the general conditions of the preterm patient is the early initiation of total parenteral nutrition (TPN) to ensure an adequate caloric protein intake, avoid malnutrition and improve nutritional reserves. There are different modes of administration of parenteral nutrition. Material and methods: Two groups of premature patients who received TPN in continuous modality or cycled for at least 7 days were formed, all newborns under 37 weeks of gestation that met the selection criteria were chosen. Laboratory controls were taken at the beginning of the TPN (day 0) and on days 7, 14, 21 and 28 of its use, the values of bilirubins, AST, ALT, GGT, alkaline phosphatase were compared and the presence or absence was compared of cholestasis at any time of the use of TPN between both groups. Results: A prevalence of cholestasis of 19.4% was reported in all patients admitted to the NICU, with 24% in whom it was infused in continuous mode and 18.6% in those who received the nutrition in cycle mode, Wald prediction analysis was performed observing that patients with continuous TPN have a 7.6 times higher risk of presenting cholestasis than those who were infused with the cycled method (Stanford University method).

Paper No: 
1858