Parenteral Nutrition–Associated Cholestasis in Neonates: Multivariate Analysis of the Potential Protective Effect of Taurine
| Autor: | Moustafa M. Aouthmany, Jonathan I. Groner, Peter J. Strouse, Marilyn R. Brown, Thomas F. Tracy, Adolfo Llanos, Morton B. Brown, Patricia A. DeRusso, Ronald B. Hirschl, Sunkyung Yu, Jean Cox, Daniel H. Teitelbaum, Robert J. Shulman, Jacqueline Dahlgren, Ariel U. Spencer |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Parenteral Nutrition - Associated Cholestasis
Cholagogues and Choleretics Parenteral Nutrition Taurine medicine.medical_specialty 030309 nutrition & dietetics Critical Illness Medicine (miscellaneous) Gestational Age Infant Premature Diseases Placebo Enteral administration Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Double-Blind Method Cholestasis Internal medicine medicine Humans Prospective Studies Prospective cohort study 0303 health sciences Nutrition and Dietetics business.industry Infant Newborn Gestational age Bilirubin medicine.disease Parenteral nutrition Endocrinology chemistry Multivariate Analysis 030211 gastroenterology & hepatology Cholecystokinin business Infant Premature |
| Zdroj: | Journal of Parenteral and Enteral Nutrition. 29:337-344 |
| ISSN: | 1941-2444 0148-6071 |
| DOI: | 10.1177/0148607105029005337 |
| Popis: | Neonates receiving parenteral nutrition (PN) are at risk for PN-associated cholestasis (PNAC); however, no preventive factors for PNAC have been clearly identified. Despite reports suggesting that taurine may prevent PNAC in neonates, such an effect of taurine has not yet been definitively demonstrated. We determined whether taurine supplementation reduces the incidence of PNAC in premature or critically ill neonates.This study was part of a prospective, randomized, multi-institutional trial designed to assess cholecystokinin vs placebo as a potential preventive therapy of PNAC. Taurine supplementation of PN varied between institutions. The presence or absence of taurine in PN was analyzed by multivariate analysis, with a primary outcome measure of serum conjugated bilirubin (CB) as a measure of PNAC.Taurine reduced PNAC in premature infants (estimated maximum CB [95% confidence interval] 0.50 mg/dL [-0.17 to 1.18] for those receiving taurine, vs 3.45 mg/dL [1.79-5.11] for neonates not receiving taurine, approaching significance, p = .07). Taurine significantly reduced PNAC in infants with necrotizing enterocolitis (NEC; estimated maximum CB 4.04 mg/dL [2.85-5.23], NEC infants receiving taurine, vs 8.29 mg/dL [5.61-10.96], NEC infants not receiving taurine, p.01). There were too few neonates with surgical anomalies to evaluate the effect of taurine in this group.Within specific subgroups of neonatal patients, taurine supplementation does offer a very significant degree of protection against PNAC. Patients with NEC or severe prematurity are most likely to benefit substantially from taurine supplementation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text