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Journal of the Korean Society of Neonatology 2009;16(2):197-204.
Published online November 1, 2009.
Hepatobiliary Dysfunction in Very Low Birth Weight Infants Supported with Parenteral Nutrition.
Youn Hee Lee, Joong Hyun Bin, Juyoung Lee, Hyun Seung Lee, Jung Hyun Lee, So Young Kim, In Kyung Sung, Chung Sik Chun
Department of Pediatrics, University of Catholic, Seoul, Korea. sykimped@catholic.ac.kr
정맥영양 극소저체중출생아의 간담도 기능 이상
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Abstract
PURPOSE
The objective of this study was to describe the frequency of hepatobiliary dysfunction (HD) at our hospital and determine the possible risk factors and complications associated with the development of HD in very low birth weight infants (VLBWI) treated with parenteral nutrition (PN).
METHODS
A retrospective study of VLBWI (n=92) that required PN between 2004 and 2008 in the NICU at the Bucheon St. Marys Hospital of Catholic University was performed. HD was defined by a direct bilirubin (DB) >2 mg and a transaminase of 60 IU/L defined cholestasis and liver injury. Groups I, II, and III were limited to cases of cholestasis, liver injury without cholestasis, and no abnormalities, respectively. The VLBWI were compared to each other.
RESULTS
Thirty-six subjects (39.1%) had cholestasis and 51 (55.4%) had liver injury. In addition, 36 (39.1%), 19 (20.7%), and 37 (40.2%) subjects were classified as groups I, II, and III, respectively. The three groups showed significant differences in gestational age, 1- and 5-minute Apgar scores, use of surfactant, duration of parenteral nutrition, frequency of RBC transfusions, bronchopulmonary dysplasia (BPD), and patent ductus arteriosus (PDA) (P<0.05). The multiple regression analysis with cholestasis as the dependent variable, showed a significant correlation with gestational age, use of surfactant, frequency of RBC transfusions, and PDA.
CONCLUSION
Various factors, such as birth weight, gestational age, 1- and 5-minute Apgar scores, use of surfactant for respiratory distress syndrome (RDS), frequency of RBC transfusions, BPD, and PDA may be related to hepatobiliary dysfunction in VLBWI treated with PN.
Key Words: Hepatobiliary dysfunction, Very low birth weight infants, Cholestasis, Parenteral nutrition


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