Early central catheter infections may contribute to hepatic fibrosis in children receiving long-term parenteral nutrition
(2007) Journal of Pediatric Gastroenterology and Nutrition — Vol. 44, n° 4, p. 459-463 (2007)
Files
10919.pdf
Restricted Access - Adobe PDF
- 2.14 MB
Details
- Authors
- Abstract
- BACKGROUND: Bacterial infections in infants constitute a risk factor for parenteral nutrition (PN)-related cholestasis. The possible role of infections in the development of liver fibrosis, the most severe long-term complication, has yet to be documented. This study retrospectively compares the incidence of sepsis in children with and without severe liver fibrosis. PATIENTS AND METHODS: Medical reports of 30 children in prolonged PN programs between March 1985 and March 2000 were reviewed. Starting at birth, the mean PN duration was 65 months (range, 8-150 months). According to the results of liver biopsy (LB), patients were split into 2 groups: group A (n = 16) with severe liver fibrosis (ie, septal fibrosis involving >50% of portal fields or cirrhosis) and group B (n = 14) with normal hepatic architecture or mild fibrosis (<50% of portal fields). RESULTS: Duration of PN at the time of LB was shorter in group A (30.5 months; range, 8-96 months) than in group B (105 months; range, 37-150 months; P < 0.001). In group A the incidence of sepsis was significantly higher than in group B (3.2 +/- 0.3/year vs 1.5 +/- 0.2/year) and the first infection occurred earlier (group A, 1 month [range, 1-2 months]; group B, 4 months [range, 1-19 months]). By contrast, both groups were similar in terms of pregnancy duration, birth weight, age of PN onset, underlying diseases, mode of PN delivery, and number of cholestasis episodes. CONCLUSIONS: Incidence and early onset of infections may contribute to the development of liver fibrosis in cases of long-term PN. New strategies are required in prevention and treatment of infections in children receiving PN.
- Affiliations
Citations
Hermans, D., Talbotec, C., Lacaille, F., Goulet, O., Ricour, C., & Colomb, V. (2007). Early central catheter infections may contribute to hepatic fibrosis in children receiving long-term parenteral nutrition. Journal of Pediatric Gastroenterology and Nutrition, 44(4), 459-463. https://doi.org/10.1097/MPG.0b013e318031a5c7 (Original work published 2007)