دورية أكاديمية
Lipid-Free Parenteral Nutrition Is Associated with an Increased Risk of Hepatic Dysfunction in Surgical Critically Ill Patients: A Retrospective Observational Study.
العنوان: | Lipid-Free Parenteral Nutrition Is Associated with an Increased Risk of Hepatic Dysfunction in Surgical Critically Ill Patients: A Retrospective Observational Study. |
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المؤلفون: | Wu SC; School of Medicine, China Medical University, Taichung 404, Taiwan.; Trauma and Emergency Center, China Medical University Hospital, Taichung 404, Taiwan., Chen TA; Department of Surgery, China Medical University, Taichung 404, Taiwan., Tsai IJ; Management Office for Health Data, China Medical University and Hospital, Taichung 404, Taiwan., Wang YC; Department of Surgery, China Medical University, Taichung 404, Taiwan., Cheng HT; Department of Surgery, China Medical University, Taichung 404, Taiwan., Tzeng CW; Department of Surgery, China Medical University, Taichung 404, Taiwan., Hsu CH; Department of Surgery, China Medical University, Taichung 404, Taiwan., Muo CH; Management Office for Health Data, China Medical University and Hospital, Taichung 404, Taiwan. |
المصدر: | Healthcare (Basel, Switzerland) [Healthcare (Basel)] 2021 Aug 25; Vol. 9 (9). Date of Electronic Publication: 2021 Aug 25. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101666525 Publication Model: Electronic Cited Medium: Print ISSN: 2227-9032 (Print) Linking ISSN: 22279032 NLM ISO Abbreviation: Healthcare (Basel) Subsets: PubMed not MEDLINE |
أسماء مطبوعة: | Original Publication: Basel, Switzerland : MDPI AG, [2013]- |
مستخلص: | To evaluate the effects of lipid-free parenteral nutrition (PN) and various intravenous fat emulsions (IVFEs) on hepatic function in surgical critically ill trauma/acute care surgery patients. We retrospectively reviewed trauma/acute care surgery patients without admission hepatic disorder that received PN. The PN groups include lipid-free, soybean oil/medium-chain triglyceride, olive oil-based, and fish-oil contained PN. We excluded patients with (1) age <18 years, (2) without surgery, (3) preexisting liver injury/diseases, (4) hyperbilirubinemia at admission, (5) received more than one type of PN, and (6) repeated ICU episodes in the same hospitalization. Hepatic dysfunction was considered as serum total-bilirubin >6.0 mg/dL. The demographics, severity score, comorbidities, blood stream infection, and mortality were collected for analyses. The major outcome is hepatic function. We also performed analyses stratified by separated lipid doses (g/kg/day). A total of 249 patients were enrolled. There were no demographic differences among groups. The lipid-free PN group had a higher incidence of hepatic dysfunction and mortality. Compared to the lipid-free group, the other three IVFEs had significantly lower risks of hepatic dysfunction, while the olive oil-based group had a significantly lower risk of 30 and 90-day mortality. After being stratified by separating lipid doses, the soybean oils showed a decreasing trend of hepatic dysfunction and mortality with increased dosage. Fish oil >0.05 g/kg/day was associated with lower hepatic dysfunction incidences. Our findings suggest that, when compared to IVFEs, surgical critically ill patients with trauma/acute care surgery that received lipid-free PN are associated with an increased risk of hepatic dysfunction. In addition, the olive oil-based group had a significantly lower risk of mortality, while fish oil >0.05 g/kg/day was associated with lower incidences of hepatic dysfunction; however, further studies are warranted. |
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معلومات مُعتمدة: | 109-TDU-B-212-114004 Ministry of Health and Welfare; MOST 108-2321-B-039-003 MOST Clinical Trial Consortium for Stroke |
فهرسة مساهمة: | Keywords: hepatic function; intravenous fat emulsion; parenteral nutrition; surgical critically ill; trauma/acute care surgery |
تواريخ الأحداث: | Date Created: 20210928 Latest Revision: 20211001 |
رمز التحديث: | 20231215 |
مُعرف محوري في PubMed: | PMC8467940 |
DOI: | 10.3390/healthcare9091096 |
PMID: | 34574872 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2227-9032 |
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DOI: | 10.3390/healthcare9091096 |