Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background and aim: Parenteral nutrition (PN) is an effective method of nourishing the neonate who is unable to receive full enteral feeds. However, prolonged PN increases the incidence of parenteral nutrition associated cholestasis (PNAC) in preterm infants. The aim of this study was to determine the incidence of total parenteral nutrition-associated cholestasis and to develop possible predictive risk factors for its occurrence. Methods: A cross-sectional study on 200 preterm infants receiving TPN, were enrolled from NICU, Cairo University. The infants were divided into two groups: Cholestatic and noncholestatic, based on direct serum bilirubin level >2mg/dl. Clinical, laboratory and sonographic data were compared between the 2 groups. Results: A total of 200 patients were included in the study. The incidence of parenteral nutrition associated cholestasis in the whole population was 19.5%. Infants with cholestasis had a lower birth weight, than noncholestatic group (p-value <0.05). Patients in cholestatic group received TPN for longer duration than in non cholestatic group (p-value <0.05) and protein and glucose content were higher in cholestatic patients than non cholestatic (p-value 0.029 and 0.042). There were statistically significant higher values in CRP, positive blood culture and sepsis score between cholestatic and non cholestatic groups after start of TPN administration (p-value <0.05)

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