接受静脉注射鱼油治疗的儿童术后出血风险。
Risk of post-procedural bleeding in children on intravenous fish oil.
作者信息
Nandivada Prathima, Anez-Bustillos Lorenzo, O'Loughlin Alison A, Mitchell Paul D, Baker Meredith A, Dao Duy T, Fell Gillian L, Potemkin Alexis K, Gura Kathleen M, Neufeld Ellis J, Puder Mark
机构信息
Vascular Biology Program and the Department of Surgery, Boston Children's Hospital, Boston, MA, USA.
Clinical Research Center, Biostatistics Core, Boston Children's Hospital, Boston, MA, USA.
出版信息
Am J Surg. 2017 Oct;214(4):733-737. doi: 10.1016/j.amjsurg.2016.10.026. Epub 2016 Dec 1.
BACKGROUND
Intestinal failure-associated liver disease (IFALD) can be treated with parenteral fish oil (FO) monotherapy, but practitioners have raised concerns about a potential bleeding risk. This study aims to describe the incidence of clinically significant post-procedural bleeding (CSPPB) in children receiving FO monotherapy.
METHODS
A retrospective chart review was performed on patients at our institution treated with intravenous FO for IFALD. CSPPB was defined as bleeding leading to re-operation, transfer to the intensive care unit, re-admission, or death, up to one month after any invasive procedure.
RESULTS
From 244 patients reviewed, 183 underwent ≥1 invasive procedure(s) (n = 732). Five (0.68%, 95% CI 0.22-1.59%) procedures resulted in CSPPB. FO therapy was never interrupted. No deaths due to bleeding occurred.
CONCLUSIONS
Findings suggest that FO therapy is safe, with a CSPPB risk no greater than that reported in the general population. O3FA should not be held in preparation for procedures or in the event of bleeding.
背景
肠衰竭相关肝病（IFALD）可用肠外鱼油（FO）单一疗法治疗，但从业者对潜在的出血风险表示担忧。本研究旨在描述接受FO单一疗法的儿童发生具有临床意义的术后出血（CSPPB）的发生率。
方法
对我院接受静脉注射FO治疗IFALD的患者进行回顾性病历审查。CSPPB定义为在任何侵入性操作后长达1个月内导致再次手术、转入重症监护病房、再次入院或死亡的出血。
结果
在审查的244例患者中，183例接受了≥1次侵入性操作（n = 732）。5例（0.68%，95%CI 0.22 - 1.59%）操作导致CSPPB。FO治疗从未中断。未发生因出血导致的死亡。
结论
研究结果表明，FO治疗是安全的，CSPPB风险不高于普通人群报告的风险。在准备进行操作或发生出血时，不应停用ω-3脂肪酸（O3FA）。
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