Intestinal failure associated cholestasis in surgical necrotizing enterocolitis and spontaneous intestinal perforation
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In brief
In brief
Retrospective Finnish study of 225 neonates who underwent surgery for NEC or SIP examines intestinal failure-associated cholestasis (IFAC) incidence and outcomes. IFAC developed in 42% of survivors requiring prolonged parenteral nutrition, with unresolved cholestasis strongly associated with mortality.
Written by the GCMD Library team from the article.
Background
Surgery for necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) is often complicated by intestinal failure (IF) and intestinal failure associated cholestasis (IFAC).
Objective
Assessment of incidence, predictors, and mortality associated with IFAC in surgically treated NEC and SIP.
Methods: A retrospective observational study based on hospital records during 1986–2014 in the two largest Finnish neonatal intensive care units was performed. IFAC was defined as conjugated bilirubin >34 μmol/l (2.0 mg/dl) for ≥ two postoperative weeks while receiving parenteral nutrition (PN).
Results
In total 225 patients underwent surgery for NEC (n = 142; 63%) or SIP (n = 83; 37%). Included were 57 survivors with ≥two weeks PN. Sixty-five (42%) patients developed IFAC. Two-year survival with IFAC was 80% and without IFAC 89% (p = 0.13). Of the 65 patients with IFAC, all eight with unresolved IFAC died in comparison to six of 57 (11%) whose IFAC resolved (p