Cholestasis in Extreme Low Birth Weight Infants (ELBW)
Parenteral nutrition associated liver disease (PNALD) in preterm neonates is characterized by early occurrence of intrahepatic cholestasis (parenteral nutrition associated cholestasis (PNAC).
Extreme low birth weight infants (ELBW, birth weight < 1000 g) are at increased risk for development of PNAC.
Important factors implicated in the aetiology of PNAC are high caloric parenteral nutrition using amino acids or dextrose, but also intravenous lipids and infections in particular necrotizing enterocolitis (NEC).
Due to a change of paradigm a more aggressive nutrition with early use of parenteral amino acids/lipids and early fortification of mothers milk or alternatively high caloric preterm formula is warranted. Accordingly - in line with the existing expert opinion and evidence - the feeding policy at the neonatal care units of our hospital was adapted.
Evidence exists that PNAC might be caused by the use of high concentrations of amino acids and lipids in parenteral nutrition. Furthermore NEC is associated with high osmotic feeds. Therefore the incidence of PNAC might be increased directly and indirectly after introducing the new feeding policy.
The investigators therefore aim at retrospectively investigating the incidence of PNAC before and after introduction of a feeding policy of "aggressive nutrition" for ELBW infants.
|Study Design:||Observational Model: Cohort
Time Perspective: Retrospective
|Official Title:||Cholestasis in Extreme Low Birth Weight Infants (ELBW) - Possible Influences of a Change in Nutrition Policy|
- Cholestasis [ Time Frame: Assessment of bilirubin levels at least every second week from birth (0 weeks) to discharge (i.e. up to an average of 12 weeks) ] [ Designated as safety issue: No ]Conjugated Bilirubin > 1.5 mg/dl at two measurements
- Growth [ Time Frame: At study entry (after birth, 0 weeks) and discharge (i.e. at an average of 12 weeks) ] [ Designated as safety issue: No ]Body weight, head circumference and heel-crown length assessed at birth and at discharge from or transfer to another hospital
|Study Start Date:||January 2010|
|Study Completion Date:||July 2010|
|Primary Completion Date:||June 2010 (Final data collection date for primary outcome measure)|
ELBW infants before change of feeding policy
ELBW infants after change of feeding policy