Fish Oil Based Lipid Emulsions for the Treatment of Intestinal Failure Associated Liver Disease: Nothing Fishy About it!

Excerpt

Intestinal failure (IF) is a condition in which the gut is unable to provide adequate nutrient and fluid requirements for the maintenance of metabolic functions and growth in children. Long-term parenteral nutrition (PN) is the backbone of management, however it is complicated by intestinal failure associated liver disease (IFALD) in ~20% children [1]. IFALD is defined as hepatic dysfunction as a consequence of the medical and surgical management strategies for IF. Serum bilirubin is a marker of IFALD, value of >1.2 mg/dl is considered a “red flag” and > 5.8 mg/dl is suggestive of marked liver injury [1]. IFALD varies in severity from biochemical cholestasis to end stage liver disease requiring liver ± intestinal transplantation. Risk factors for IFALD include prematurity, lack of enteral nutrition, sepsis, longer duration and constituents of PN [1]. …