1.
Evaluation of parenteral nutrition-associated liver disease in surgical infants for necrotizing enterocolitis.
Zeng, S, Li, X, Deng, C, Li, L, Guo, C
Medicine. 2020;(2):e18539
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Abstract
The purpose of this study was to determine the factors associated with parenteral nutrition-associated liver disease (PNALD) in infants who underwent surgery for necrotizing enterocolitis (NEC) and followed up the postoperative outcomes for long term parenteral nutrition (PN).This study included a retrospective review of 87 infants with NEC and managed surgically from July 2007 to May 2017 at the Children's Hospital, Chongqing Medical University. Clinical data and procedure information were collected and analyzed.Among the infants included, 16.1% of patients developed PNALD. Multivariable logistic regression analysis revealed progressive clinical deterioration (OR, 5.47; 95% CI, 1.10-26.96; Pā=ā.037) was independent risk factor for PNALD whereas congenital heart disease (OR, 0.068; 95% CI, 0.008-0.55; Pā=ā.012) presentation served as a protective factor.The current data suggested the distinct disease process for cardiac patients with NEC, which might help in the prevention and treatment of PNALD for patients with NEC.
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The effects of a short-term long-chain-triglyceride infusion on the postoperative immune function of pediatric patients receiving a gastrointestinal surgical procedure.
Li, X, Ying, J, Zeng, S, Li, Y, Yang, H, Shen, L, Han, J, Chen, J, Shen, H
JPEN. Journal of parenteral and enteral nutrition. 2008;(1):72-7
Abstract
OBJECTIVE This clinical trial investigates whether short-term administration of long chain triglycerides (LCT) has any influence on the immune function in children following gastrointestinal surgery. METHODS Sixty pediatric patients receiving a gastrointestinal operation were randomly divided into the experimental group (n = 36) and the control group (n = 24). After abdominal operation, the subjects received parenteral nutrition (PN) support with or without LCT for 5 days. The patients' fasting blood samples were respectively collected at 24 hours preoperative, then 24 hours and 120 hours postoperative. Blood parameters related to the patients' immune function were measured. RESULTS Before surgery and LCT treatment, the experimental group and control group did not differ significantly in overall state of health. Except for a small increase of serum IgM at 24 hours postsurgery (p < .05), all parameters representing the patients' immune function showed no significant difference between the LCT group and the control group with respect to peripheral blood mononuclear cell (PBMC), T lymphocyte, CD4, CD8, CD4/CD8, serum immunoglobulin A (IgA), IgG, IgM, complement C3, C4, interleukin (IL)-2, IL-4, IL-10, IL-12, tumor necrosis factor (TNF)-alpha and IFN-gamma (p > .05, respectively) before the operation, 24 hours and 120 hours after the operation. CONCLUSIONS A short-term LCT administration at an appropriate dosage and infusion speed does not alter the pediatric patients' immune function after gastrointestinal surgery. The etiology and clinical significance of the slightly increased IgM 24 hours postsurgery need to be further investigated.
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A short-term long-chain triglycerides infusion has no influence on immune function of adult patients undergoing gastrointestinal surgery.
Li, X, Ying, J, Zeng, S, Shen, L, Wan, X, Li, X, Tan, H, Pei, H, Zhou, J, Shen, H
JPEN. Journal of parenteral and enteral nutrition. 2007;(3):167-72
Abstract
BACKGROUND Parenteral nutrition (PN) support containing long-chain triglycerides (LCT) plays a critical supportive role in surgical patients' management. This study aims to investigate the effects of intravenous (IV) LCT emulsion on human immune function in adult patients receiving a gastrointestinal surgical procedure. METHODS Sixty adult patients were randomly assigned either to the LCT treatment group (n = 32) or to the control group (n = 28). After an abdominal operation, the subjects received PN treatment with or without LCT for 5 days. Neutrophil, peripheral blood mononuclear cell (PBMC), lymphocyte and CD4/CD8, serum immunoglobulin A (IgA), IgG, IgM, complement C3 and C4, interleukin (IL)-2, IL-4, IL-10, IL-12, tumor necrosis factor (TNF)-alpha, and interferon (IFN)-gamma were measured and statistically analyzed. RESULTS The LCT and control groups did not differ significantly at entry in terms of general features. Except for a significant increase of neutrophil number at 24 hours after the surgery in both groups (p < .01), all parameters representing the patients' immune function had no significant difference between the LCT and the control groups with respect to neutrophil and PBMC count, lymphocyte, CD4/CD8, serum IgA, IgG, IgM, complement C3, C4, IL-2, IL-4, IL-10, IL-12, TNF-alpha, and IFN-gamma (p > .05, respectively) 24 hours before the operation, and 24 hours and 120 hours after the operation. CONCLUSIONS The regimens of LCT administration may have diverse effects on human immune function in different patient populations. However, LCT emulsion at an appropriate dose and infusion speed does not alter human immune function of adult patients undergoing moderate gastrointestinal surgery.