期刊
CLINICS IN LIVER DISEASE
卷 21, 期 4, 页码 687-695出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.cld.2017.06.008
关键词
TPN; PNALD; Cholestasis of sepsis; Combined intestinal and liver failure
Parenteral nutrition associated liver disease (PNALD) spectrum ranges from liver enzyme abnormalities to steatosis to fibrosis, and, eventually, cirrhosis from total parenteral nutrition (TPN). The pathophysiology is postulated to be multifactorial. Diagnosis in adults is primarily by exclusion, eliminating other causes of chronic liver disease or cirrhosis, and other factors seen in critically ill or postoperative patients on TPN. Principal treatment is avoiding TPN. If this is not feasible, research supports fish oil based lipid emulsions in TPN formulations to reduce risk and progression of PNALD. With liver and intestinal failure, liver and intestine transplantation is an option.
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