PARENTERAL NUTRITION-ASSOCIATED CHOLESTASIS: THE INCIDENCE AND EXAMINATION OF THE ROLE OF ALUMINUM CONTAMINATION
| dc.contributor.committeeMember | Wonko, Neil | |
| dc.contributor.committeeMember | Paterson, Phyllis | |
| dc.creator | Arnold, Chris | |
| dc.date.accessioned | 2023-11-02T20:33:58Z | |
| dc.date.available | 2023-11-02T20:33:58Z | |
| dc.date.issued | 2004-06 | |
| dc.date.submitted | June 2004 | en_US |
| dc.description.abstract | Parenteral nutritional (PN) support is an essential component in the care of ill neonates. Parenteral nutrition-associated cholestasis (PN-AC) is a complication of PN that was first described in 1971 and still defies clear etiological delineation. The objective of the first project was to establish the prevalence of PN-AC at the Royal University Hospital by retrospectively studying infants. Sixty-four infants with the diagnoses of gastroschisis, intestinal atresia, intestinal stenosis, necrotizing enterocolitis, imperforate anus, or Hirschprung's disease had their medical records reviewed. Cholestasis was diagnosed clinically by a serum direct bilirubin concentration exceeding 34 mmol/L. We found that 16 of the 64 (25%) neonates in our study developed cholestasis. In the neonates who developed cholestasis, the average number of days on parenteral nutrition was 18.4 days (range 5-39 days). A forward stepwise multiple regression analysis was performed revealing that the length of time on parenteral nutrition, gastrointestinal surgery, and birth weight together significantly predict the development of PN-AC (p < 0.001). A second study was to prospectively enrol neonates at risk for intestinal failure with the primary focus being to examine the relationship between serum aluminum concentrations and serum direct bilirubin concentrations. Eight neonates with intestinal failure receiving parenteral nutrition were enrolled. Three of eight (37.5%) of the neonates developed parenteral nutrition-associated cholestasis. Significant differences were found in birth weight, gestational age and number of days on parenteral nutrition between those neonates that developed PNAC and those that did not. No significant relationship between serum direct bilirubin and serum aluminum was found. In conclusion, at least 25% of infants who are born with low birth weight and require gastrointestinal surgery that receive parenteral nutrition therapy for 18 days developed PNAC. Further work examining the relationship between aluminum contamination of parenteral solutions and the development of PNAC is required. | en_US |
| dc.identifier.uri | https://hdl.handle.net/10388/15204 | |
| dc.subject | ALUMINUM CONTAMINATION | en_US |
| dc.subject | Parenteral nutritional | en_US |
| dc.title | PARENTERAL NUTRITION-ASSOCIATED CHOLESTASIS: THE INCIDENCE AND EXAMINATION OF THE ROLE OF ALUMINUM CONTAMINATION | en_US |
| dc.type.genre | Thesis | en_US |
| thesis.degree.department | Nutrition and Dietetics | en_US |
| thesis.degree.grantor | University of Saskatchewan | en_US |
| thesis.degree.level | Masters | en_US |
| thesis.degree.name | Master of Science (M.Sc.) | en_US |