Liver Disease in Patients Qualified for Home Parenteral Nutrition – A Consequence of a Failure to Adjust Rtu Bags in the Primary Centre?
Journal Title: Polish Journal of Surgery - Year 2014, Vol 86, Issue 6
Abstract
If planned improperly, parenteral nutrition may result in a number of severe metabolic complications caused by insufficient or excessive delivery of individual nutrients. One of the most common and the most dangerous complication is parenteral nutrition-associated liver disease (PNALD). Such a complication may also result from using RTU (ready-to-use) bags that are not adjusted adequately to individual patients. The aim of the study was the analysis of prevalence and determining the cause of liver disease in patients who had been receiving parenteral nutrition in primary centres prior to the implementation of home parenteral nutrition in the specialist centre. Material and methods. The study enrolled 146 patients who were referred to the Clinic in the period of 2006–2012 in order to be qualified for home parenteral nutrition. Interview and medical documentation revealed that 100 patients had been receiving parenteral nutrition by means of ready-to-use (RTU) bags in their primary centres. In the remaining 46 patients, such feeding had not been implemented. Upon admission, the following parameters were evaluated: bilirubin, aspartate aminotransferase (AspAT), alanine aminotransferase (AlAT), lactate dehydrogenase (LDH), gamma-glutamyltranspeptidase (GGTP), alkaline phosphatase (AP), triglycerides (TG), cholesterol, protein, albumins, amylase, urea, creatinine and C-reactive protein (CRP). The analysis of the results was conducted with the use of the Student’s T-test. Results. The patients who had been receiving parenteral nutrition manifested significantly increased (p < 0.05) levels of total bilirubin, TG, AlAT, LDH, GGTP, AP and CRP. 23% of patients were diagnosed with jaundice, in 70%, GGTP > 100 i.u. and a half manifested biochemical features of cholestasis. No correlation was observed between the CRP level and results of liver function tests. Conclusions. It was found that there is a correlation between parenteral nutrition with RTU bags and liver disease. The probable cause of liver disease associated with parenteral nutrition received prior to the transfer to the Clinic is excessive administration of lipids. It can be accompanied by excessive administration of glucose. Modification of parenteral nutrition helped to compensate for liver disorders in all patients.
Authors and Affiliations
Michał Ławiński, Agnieszka Bzikowska, Mohammad Omidi, Krystyna Majewska, Urszula Zielińska-Borkowska
Keywords
Related Articles
- EP ID EP74412
- DOI 10.2478/pjs-2014-0049
- Views 98
- Downloads 0
Assessment Of the surgical treatment results IN patients with colorectal cancer IN A district hospital versus treatment results IN A highly specialized center
In Poland there there are about 15-16 thousand cases of colon cancer per year. The health care system allows the treatment of patients with colorectal cancer in highly specialized hospitals, oncology centers and district...
Wpływ operacji bariatrycznych na przebieg niealkoholowej stłuszczeniowej choroby wątroby
Wstęp: prawie 300 milionów ludzi na świecie BMI przekracza 30 (kg/m2). Otyłość jest przyczyną wielu poważnych schorzeń, takich jak cukrzyca typu 2, nadciśnienie tętnicze czy niealkoholowe stłuszczenie wątroby. Chirurgia...
Rare Case of Multifocal (Adrenal and Extra - Adrenal ) Myelolipoma
Torsed Intraabdominal Testicular Tumor Diagnosed during Surgery Performed due to Suspicion of Acute Appendicitis
Roux-en-y biliary by-pass – a new approach in the treatment of hypertriglyceridemia induced recurrent acute pancreatitis. Clinical case study
Acute pancreatitis is a disease with significant mortality. Hypertriglyceridemia (HTG) is the third most common etiological factor of this disorder after alcohol and gall-stones. The authors presented a case of 42-years...