J Korean Soc Neonatol.  2004 Nov;11(2):210-217.

Clinical Effects of Ursodeoxycholic Acid on Total Parenteral Nutrition Induced Cholestasis in Premature Infants

• Song ES
• Kim JY
• Kim SY
• Byun HS
• Choi YY

Abstract

PURPOSE
Cholestatic liver disease is a frequent complication of prolonged parenteral nutrition, especially in premature infants. The purpose of present study is to evaluate the clinical and biochemical efficacy of ursodeoxycholic acid (UDCA) in premature infants with total parenteral nutrition (TPN) cholestasis. METHODS: Retrospective chart review of 31 prematures with TPN cholestasis in Neonatal Intensive Care Unit of Chonnam University Hospital from January 1995 and December 2002 was done. Prematures were divided into two groups based on UDCA treatment: the study group (n=22, with UDCA treatment) and the control group (n=9, without UDCA treatment). Treatment efficacy of UDCA was evaluated by monitoring the changes of serum direct bilirubin level for more than one to two months. RESULTS: In study group, cholestasis appeared at a mean age of 23+/-18.8 days after a mean of 21+/-19.7 days of TPN. UDCA was initiated (ranged 15-30 mg/kg/day) at a mean age of 54+/-22.3 days for a mean of 32+/-19.0 days. There was no significant difference in decrease of direct bilirubin level between the study and control group. However, the day of initial enteral feeding and full enteral feeding were earlier in control group compared with study group. CONCLUSIONS: This study shows that UDCA treatment is not effective in the treatment of TPN cholestasis among premature infants unlike that of results reported in children and adults. To reduce the incidence of TPN cholestasis in premature infants, early introduction of enteral feeding as soon as possible is most important.

Keyword

Total parenteral nutrition; Cholestasis; Premature; Ursodeoxycholic acid

MeSH Terms

Adult
Bilirubin
Child
Cholestasis*
Enteral Nutrition
Humans
Incidence
Infant, Newborn
Infant, Premature*
Intensive Care, Neonatal
Jeollanam-do
Liver Diseases
Parenteral Nutrition
Parenteral Nutrition, Total*
Retrospective Studies
Treatment Outcome
Ursodeoxycholic Acid*
Bilirubin
Ursodeoxycholic Acid