Abstract:

AIM: To investigate the effect of MCT/LCT and LCT fat emulsion on the incidence of parenteral nutrition-associated cholestasis (PNAC) in preterm infants that accept long-term parenteral nutrition (PN) so as to provide a reference for the choice of neonatal PN fat emulsion, and to explore the protective factors of PNAC.  METHODS: This retrospective analysis was conducted on hospitalization data of preterm infants (gestational age 29-34 weeks) that received PN for more than 14 days in March 2015 and March 2016 in NICU. Different types of fat emulsion were used in these two periods; the occurrence of PNAC was compared. Then the patients with the same condition were collected from March 2016 to September 2016, and these patients were divided into two groups (≥3 g·kg-1·d-1 group and ≤2 g·kg-1·d-1 group) according to the daily maximum dosage of LCT fat emulsion. The occurrence of cholestasis was compared in the two groups.RESULTS:Compared with MCT/LCT, the incidence of PNAC was significantly increased in LCT group.The patients that received ≥3 g·kg-1·d-1 daily maximum dosage of LCT has a higher incidence of PNAC and lipid accumulative amount; and the time to reach the whole gastrointestinal nutrition was longer as well as the hospital stay. CONCLUSION: LCT is more likely to cause cholestasis. Reducing the accumulative amount of fat emulsion and daily maximum dosage, achieving total gastrointestinal nutrition as soon as possible are protective factors of PNAC.

Key words: MCT/LCT, LCT, parenteral nutrition-associated cholestasis, daily maximum dose