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- W2143142428 abstract "TPN associated cholestasis (TAC) continues to be a significant problem in infants requiring chronic parenteral nutrition. Parenteral protein (PP) has been implicated as one of the most significant contributors to the development of TAC. We report the resolution of TAC in 4 children with short bowel syndrome SBS by switching all PP to the enteral route while maintaining fluid and energy delivery parenterally. Patients: 4 children with (SBS) secondary to volvulus, intestinal atresia, trauma and pseudobstruction, ages 3,3,39 and 62 months respectively. Patients were receiving an average of 69 (range 59-82) Cal/kg/d parenterally at the time of intervention, and had developed TAC. Due to severe fat and CHO malabsorption enteral energy could not be advanced further. Intervention: PP was discontinued while maintaining parenteral fluid, dextrose and fat. Simultaneously, an enteral protein hydrolysate module (Elementra, Clintec Nut.) was used to deliver all of the patients' protein requirements: 3.3 (range 2.7-3.7) g/kg/day. Thus fluid and energy requirements were maintained parenterally and all protein requirements maintained enterally without increasing enteral fat or CHO which were not tolerated. This was followed by resolution of TAC in all 4 patients. The table shows the maximum bilirubin and AST values prior to and following intervention: Conclusion: Use of a high protein enteral formulation allowed discontinuation of PP while maintaining the patients' energy and fluid requirements parenterally and resulted in resolution of TAC." @default.
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- W2143142428 date "1996-10-01" @default.
- W2143142428 modified "2023-09-25" @default.
- W2143142428 title "40 RESOLUTION OF TPN ASSOCIATED CHOLESTASIS FOLLOWING DISCONTINUATION OF PARENTERAL PROTEIN" @default.
- W2143142428 doi "https://doi.org/10.1097/00005176-199610000-00070" @default.
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