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Báo cáo khoa học: " Development of liver dysfunction under artificial nutrition: a reason to modify nutrition therapy in the intensive care unit"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Development of liver dysfunction under artificial nutrition: a reason to modify nutrition therapy in the intensive care unit? | Available online http ccforum.eom content 11 1 112 Commentary Development of liver dysfunction under artificial nutrition a reason to modify nutrition therapy in the intensive care unit Peter Stehle Department of Nutrition and Food Sciences - Nutrition Physiology University of Bonn Endenicher Allee 11-13 D-53115 Bonn Germany Corresponding author Peter Stehle p.stehle@uni-bonn.de Published 19 February 2007 This article is online at http ccforum.com content 11 1 112 2007 BioMed Central Ltd Critical Care 2007 11 112 doi 10.1186 cc5679 See related research by Grau et al. http ccforum.com content 11 1 R10 Abstract Actual research suggests that artificial nutrition in critically ill patients can be associated with alterations in liver dysfunction biomarkers such as enzymes and serum bilirubin. In addition to known patient-dependent and nutrient-dependent factors the time of initiation of nutrition therapy seems to influence the risk of altered biomarkers whereas age and gender weight range of clinical scores type of primary diagnosis necessity for mechanical ventilation and the composition of the lipid emulsion used within total parenteral nutrition had no significant effects. This commentary analyzes these new results in the light of known relationships between illness and artificial nutrition therapy. In this issue Grau and colleagues 1 report the results of a multicentre study performed in 40 Spanish intensive care units ICUs dealing with the development of hepatobiliary disorders under artificial nutrition. This problem is not new in 1971 Peden and colleagues first described total parenteral nutrition TPN as a cause of hepatic dysfunction 2 . Today three types of hepatic disorder can be related to parenteral nutrition PN and to a smaller extent to enteral nutrition EN steatosis cholestasis and gallstones 3 . Prevalence rates published in recent review papers varied from 25 to 100 in adults and from 7.4 to 84 in pediatric patients 3 4 . Diagnosis of PN-associated .