USDA/ARS Children's Nutrition Research Center, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
Nutrients. 2021 Feb 4;13(2):508. doi: 10.3390/nu13020508.
Total parenteral nutrition (TPN) is a life-saving intervention for infants that are unable to feed by mouth. Infants that remain on TPN for extended periods of time are at risk for the development of liver injury in the form of parenteral nutrition associated cholestasis (PNAC). Current research suggests the lipid component of TPN is a factor in the development of PNAC. Most notably, the fatty acid composition, vitamin E concentration, and presence of phytosterols are believed key mediators of lipid emulsion driven PNAC development. New emulsions comprised of fish oil and medium chain triglycerides show promise for reducing the incidence of PNAC in infants. In this review we will cover the current clinical studies on the benefit of fish oil and medium chain triglyceride containing lipid emulsions on the development of PNAC, the current constituents of lipid emulsions that may modulate the prevalence of PNAC, and potential new supplements to TPN to further reduce the incidence of PNAC.
全胃肠外营养（TPN）是一种拯救生命的干预措施，适用于无法经口进食的婴儿。长期接受 TPN 的婴儿有发生胆汁淤积性肠外营养相关性肝损伤（PNAC）的风险。目前的研究表明，TPN 的脂质成分是 PNAC 发展的一个因素。值得注意的是，脂肪酸组成、维生素 E 浓度和植物固醇的存在被认为是脂乳剂驱动的 PNAC 发展的关键介质。由鱼油和中链甘油三酯组成的新型乳剂有望降低婴儿 PNAC 的发生率。在这篇综述中，我们将介绍关于鱼油和含中链甘油三酯的脂乳剂在 PNAC 发展中的益处的临床研究、可能调节 PNAC 发生率的脂乳剂的现有成分，以及潜在的新的 TPN 补充剂，以进一步降低 PNAC 的发生率。
