Fish Oil Based Lipid Emulsions for the Treatment of Intestinal Failure Associated Liver Disease: Nothing Fishy About it!
- 22 Downloads
Intestinal failure (IF) is a condition in which the gut is unable to provide adequate nutrient and fluid requirements for the maintenance of metabolic functions and growth in children. Long-term parenteral nutrition (PN) is the backbone of management, however it is complicated by intestinal failure associated liver disease (IFALD) in ~20% children . IFALD is defined as hepatic dysfunction as a consequence of the medical and surgical management strategies for IF. Serum bilirubin is a marker of IFALD, value of >1.2 mg/dl is considered a “red flag” and > 5.8 mg/dl is suggestive of marked liver injury . IFALD varies in severity from biochemical cholestasis to end stage liver disease requiring liver ± intestinal transplantation. Risk factors for IFALD include prematurity, lack of enteral nutrition, sepsis, longer duration and constituents of PN .
In this issue, Miura et al. report a premature infant with short bowel syndrome on PN who developed IFALD, which was successfully treated...
Compliance with Ethical Standards
Conflict of Interest
- 1.Lacaille F, Gupte G, Colomb V, et al. ESPGHAN Working Group of Intestinal Failure and Intestinal Transplantation. Intestinal failure-associated liver disease: a position paper of the ESPGHAN Working Group of Intestinal Failure and Intestinal Transplantation. J Pediatr Gastroenterol Nutr. 2015;60:272.Google Scholar
- 2.Miura W, Nagano N, Kato R, et al. Intestinal failure-associated liver disease and eicosapentaenoic acid/arachidonic acid ratio. Indian J Pediatr 2019 Feb 13. https://doi.org/10.1007/s12098-019-02895-7. [Epub ahead of print].
- 3.Hojsak I, Colomb V, Braegger C, et al. ESPGHAN Committee on Nutrition. ESPGHAN Committee on Nutrition Position Paper. Intravenous lipid emulsions and risk of hepatotoxicity in infants and children: a systematic review and meta-analysis. J Pediatr Gastroenterol Nutr. 2016;62:776.Google Scholar
- 6.Wang C, Venick RS, Shew SB, et al. Long-term outcomes in children with intestinal failure-associated liver disease treated with 6 months of intravenous fish oil followed by resumption of intravenous soybean oil. J Parenter Enter Nutr. 2018 Nov 8. https://doi.org/10.1002/jpen.1463 [Epub ahead of print].