Enteral fish oil for treatment of parenteral nutrition-associated liver disease in six infants with short-bowel syndrome.

Study Objective: To evaluate the use of enteral fish oil for the treatment of parenteral nutrition-associated liver disease (PNALD).

Design: Retrospective case series.

Setting: Pediatric academic hospital and outpatient clinic.

Evaluation of microbial contamination associated with different preparation methods for neonatal intravenous fat emulsion infusion.

Purpose: Microbial contamination associated with different methods of neonatal intravenous fat emulsion (IVFE) preparation and delivery was evaluated.

Methods: Sterility testing was performed on IVFE dispensed via three different methods: (1) in the original container (n = 60), (2) repackaged into a syringe (n = 90), and (3) drawdown of the original container (n = 60). At the end of each infusion (24 hours for methods 1 and 3, 12 hours for method 2), a sample of the IVFE was withdrawn from the container using a sterile syringe in an International Organization for Standardization class 5 hood and sent to the hospital microbiology laboratory, where the samples were introduced into blood culture bottles and incubated for five days.

Should adding albumin to parenteral nutrient solutions be considered an unsafe practice?

Purpose: The technical issues surrounding the use of albumin in parenteral nutrient (PN) solutions are reviewed.

Summary: Five criteria have been suggested to determine which compounds are optimal for addition to PN solutions: (1) stable dosage regimen over 24 hours, (2) pharmacokinetic profile supporting a 24-hour infusion, (3) stable PN solution infusion rate, (4) documented physical stability over at least 24 hours, and (5) documented chemical stability over at least 24 hours. Albumin is stable in solutions containing dextrose and electrolytes, but its stability in solutions containing dextrose and amino acids has not been evaluated.

Protein and nitrogen metabolism changes following closed head injury or cardiothoracic surgery in pediatric patients.

Objective: We compared markers of protein metabolism between children who had a controlled injury and an acute traumatic event. Significant protein catabolism occurs after acute severe injury. During surgery the injury is controlled and the degree of subsequent catabolism may be blunted.

Increased parathyroid hormone and decreased calcitriol during neonatal extracorporeal membrane oxygenation.

Objective: We noted that age-related normal calcium doses in neonates on venoarterial extracorporeal membrane oxygenation result in hypercalcemia. To avoid hypercalcemia and its potential consequences these infants are given one-half the normal calcium dose. We studied the pathogenesis of hypercalcemia and hypomagnesemia by evaluating calcitriol, intact parathyroid hormone, and calcitonin status during extracorporeal membrane oxygenation.

Evaluation of gastric pH and guaiac measurements in neonates receiving acid suppression therapy during extracorporeal membrane oxygenation.

Study Objectives: To assess gastric pH measurements, evaluate the frequency of guaiac-positive gastric aspirates, and characterize the appearance of gastric aspirates in neonates receiving acid suppression therapy during extracorporeal membrane oxygenation (ECMO).

Design: Retrospective, observational study.

Setting: Intensive care unit in a 225-bed tertiary care pediatric referral hospital.

Pamidronate treatment for hypercalcemia in an infant receiving parenteral nutrition.

A 17-day-old infant who was delivered 8 weeks premature underwent small bowel resection for necrotizing enterocolitis. During treatment with continuous infusions of furosemide and hydrocortisone, his total calcium concentration had increased. The calcium dose in his parenteral nutrition solution was decreased and then finally withheld.

Pamidronate in a girl with chronic renal insufficiency dependent on parenteral nutrition.

A 10-year-old 40-kg African-American female with megacystis microcolon hypoperistalsis syndrome maintained on total parenteral nutrition (TPN), with a history of metabolic bone disease and renal insufficiency, was admitted with a Candida parapsilosis central venous line infection. During her 280-day hospital stay, she had multiple episodes of bacteremia and recurrent candidemia. Furthermore, she developed pathological fractures and hip displacement with osteomyelitis due to Enterobacter.

Famotidine disposition in children and adolescents with chronic renal insufficiency.

The pharmacokinetics of intravenous famotidine (0.5 mg/kg, maximum 20 mg) were evaluated in 18 pediatric patients (ages 1-18 years) with stable, chronic renal insufficiency. Subjects were stratified by calculated creatinine clearance (Clcr) into mild (Clcr > or = 50 to < 90 mL/min/1.