Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013 Nov 6;4(6):711-7.
doi: 10.3945/an.113.004770. eCollection 2013 Nov.

Treatment of parenteral nutrition-associated liver disease: the role of lipid emulsions

Prathima Nandivada  1 , Sarah J Carlson, Melissa I Chang, Eileen Cowan, Kathleen M Gura, Mark Puder
Affiliations
Review

Treatment of parenteral nutrition-associated liver disease: the role of lipid emulsions

Prathima Nandivada et al. Adv Nutr. .

Abstract

Parenteral nutrition is a life-saving therapy for infants with intestinal failure. However, long-term parenteral nutrition carries the risk of progressive liver disease. Substantial data has implicated components of parenteral soybean oil in the pathogenesis of parenteral nutrition-associated liver disease (PNALD). Elevated serum concentrations of phytosterols, an abundance of omega-6 polyunsaturated fatty acids, and a relative paucity of α-tocopherol have been associated with the risk of cholestasis and hepatic injury observed in PNALD. Currently available treatment strategies include the reduction of the dose of administered parenteral soybean oil and/or the replacement of parenteral soybean oil with alternative parenteral lipid emulsions. The purpose of this review is to provide an overview of the pathogenetic mechanisms associated with the development of PNALD and the data evaluating currently available treatment strategies.

PubMed Disclaimer

Conflict of interest statement

Author disclosures: P. Nandivada, S. J. Carlson, M. I. Chang, and E. Cowan, no conflicts of interest. A license agreement for the use of Omegaven has been signed by Boston Children’s Hospital and Fresenius Kabi and a patent has been submitted by Boston Children’s Hospital on behalf of M. Puder and K. Gura.

References

    1. Kelly DA. Intestinal failure-associated liver disease: what do we know today? Gastroenterology. 2006;130(2 Suppl 1):S70–7 - PubMed
    1. Kaufman SS. Prevention of parenteral nutrition-associated liver disease in children. Pediatr Transplant. 2002;6:37–42 - PubMed
    1. Zambrano E, El-Hennawy M, Ehrenkranz RA, Zelterman D, Reyes-Múgica M. Total parenteral nutrition induced liver pathology: an autopsy series of 24 newborn cases. Pediatr Dev Pathol. 2004;7:425–32. - PubMed
    1. Gura KM, Lee S, Valim C, Zhou J, Kim S, Modi BP, Arsenault DA, Strijbosch RAM, Lopes S, Duggan C, et al. Safety and efficacy of a fish-oil-based fat emulsion in the treatment of parenteral nutrition-associated liver disease. Pediatrics. 2008;121:e678–86 - PubMed
    1. Sanchez SE, Braun LP, Mercer LD, Sherrill M, Stevens J, Javid PJ. The effect of lipid restriction on the prevention of parenteral nutrition-associated cholestasis in surgical infants. J Pediatr Surg. 2013;48:573–8 - PMC - PubMed

Publication types

MeSH terms