European Journal of Pediatrics

, Volume 167, Issue 2, pp 197–202 | Cite as

Could lipid infusion be a risk for parenteral nutrition-associated cholestasis in low birth weight neonates?

  • Jae Il Shin
  • Ran NamgungEmail author
  • Min Soo Park
  • Chul Lee
Original Paper


To assess whether lipid infusion could be a risk factor for parenteral nutrition-associated cholestasis (PNAC) in low birth weight neonates, 22 newborns with cholestasis (29.8 ± 1.6 weeks, 1298 ± 217 g) were compared with 22 without cholestasis (29.5 ± 1.7 weeks, 1286 ± 363 g). The mean level of peak direct bilirubin for the cholestasis group was 4.6 mg/dl compared to 1.2 mg/dl for the noncholestasis group. A univariate analysis revealed that PNAC was significantly related to duration of fasting (p = 0.008) and parenteral nutrition (p < 0.0001), days of antibiotics use (p = 0.025), positive C-reactive protein (p = 0.018) or gastric culture (p = 0.018), and feeding intolerance (p < 0.0001). Total amino acid amount (p < 0.0001), total lipid amount (p < 0.0001), and average daily lipid amount (p = 0.002) were significantly higher in the cholestasis group than in the noncholestasis group. Conversely, prenatal administration of dexamethasone was a significant protective factor of PNAC (p = 0.008). Logistic regression analysis revealed that the cumulative amount of lipid infusion was an independent risk factor for PNAC (p = 0.041; OR 1.174; CI 1.007–1.369). We suggest that decreasing the cumulative load of amino acids and intralipids with early trophic feeding, control of infection, and prenatal administration of dexamethasone could possibly attenuate the severity of PNAC.


Total parenteral nutrition Cholestasis Low birth weight neonates Lipid 



A part of this study was poster presented in the European Society for Paediatric Research (ESPR) meeting in Bilbao, Spain from 27–30 September 2003.


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Jae Il Shin
    • 1
  • Ran Namgung
    • 1
    Email author
  • Min Soo Park
    • 1
  • Chul Lee
    • 1
  1. 1.Department of Pediatrics, Yonsei University College of MedicineSeverance Children’s HospitalSeoulSouth Korea

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