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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2021.tde-17082021-084645
Document
Author
Full name
Juliana Zoboli Del Bigio
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2020
Supervisor
Committee
Tannuri, Ana Cristina Aoun (President)
Gibelli, Nelson Elias Mendes
Konstantyner, Tulio
Leone, Clea Rodrigues
Title in Portuguese
Avaliação da incidência e evolução da colestase em pacientes portadores de gastrosquise com diferentes emulsões lipídicas na nutrição parenteral
Keywords in Portuguese
Anomalias congênitas
Colestase
Emulsões gordurosas endovenosas
Gastrosquise
Nutrição parenteral
Recém-nascido
Abstract in Portuguese
Introdução: Gastrosquise é um defeito congênito da parede abdominal normalmente com necessidade de nutrição parenteral por tempo prolongado. A dificuldade em iniciar a dieta enteral, as infecções associadas e o uso prolongado de nutrição parenteral contribuem para incidência de colestase. A emulsão lipídica utilizada na nutrição parenteral é um importante fator contribuinte para colestase. Método: Estudo unicêntrico, retrospectivo com 138 pacientes com gastrosquise internados na Unidade de Cuidados Intensivos Neonatais (CTIN-2) do Instituto da Criança entre janeiro de 2009 e dezembro de 2018 que receberam nutrição parenteral. Os pacientes foram divididos em três grupos; grupo 1: os que receberam nutrição com triglicérides de cadeia média/triglicérides de cadeia longa a 10% (EL10%) ou 20% (EL20%) uma ou duas vezes na semana, grupo 2: os que receberam EL20% diariamente e grupo 3: os receberam SMOF diariamente. Foi avaliada a incidência de colestase entre os grupos e o perfil das enzimas hepáticas. Resultados: A emulsão lipídica e a NP mostraram-se como importantes agentes na colestase e o uso do SMOF não reduziu a incidência da mesma, porém apresentou uma melhor evolução nos valores da fosfatase alcalina nesse grupo. Conclusão: O tipo da EL usada na NP não alterou a incidência de colestase, porém o SMOF resultou em valores menores de fosfatase alcalina
Title in English
Incidence and evolution of cholestasis in patients with gastroschisis with different lipid emulsions in parenteral nutrition
Keywords in English
Congenital abnormalities
Fat emulsions intravenous
Gastroschisis
Infant newborn
Parenteral nutrition, Cholestasis
Abstract in English
Introduction: Gastroschisis is a congenital defect of the abdominal wall, usually requiring parenteral nutrition for a prolonged period. The difficulty in starting the enteral diet, the associated infections and the prolonged use of parenteral nutrition contribute to the incidence of cholestasis. The lipid emulsion used in parenteral nutrition is an important contributing factor to cholestasis. Method: Single-center, retrospective study with 138 patients with gastroschisis admitted to the Neonatal Intensive Care Unit (CTIN-2) of the Instituto da Criança between January 2009 and December 2018 who received parenteral nutrition. Patients were divided into three groups; group 1: those who received nutrition with medium chain triglycerides / 10% (EL10%) or 20% (EL20%) long chain triglycerides once or twice a week, group 2: those who received EL20% daily and group 3 : received them daily SMOF. The incidence of cholestasis between the groups and the profile of liver enzymes were evaluated. Results: The lipid emulsion and the PN were shown to be important agents in cholestasis and the use of SMOF did not reduce its incidence, but it showed a better evolution in the values of alkaline phosphatase in this group. Conclusion: The type of EL used in PN did not change the incidence of cholestasis, but SMOF resulted in lower values of alkaline phosphatase
 
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Publishing Date
2021-08-18
 
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