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Ursodeoxycholic acid prevention on cholestasis associated with total parenteral nutrition in preterm infants: a randomized trial. | LitMetric

Ursodeoxycholic acid prevention on cholestasis associated with total parenteral nutrition in preterm infants: a randomized trial.

World J Pediatr

Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.

Published: February 2022

AI Article Synopsis

  • Preterm infants on long-term parenteral nutrition (PN) are at risk for developing cholestasis, prompting a study on the effectiveness of ursodeoxycholic acid (UDCA) to prevent this condition.
  • A randomized trial compared oral UDCA administration to no treatment in low-birth-weight preterm infants, focusing on their bilirubin levels during their NICU stay.
  • Results showed that infants receiving UDCA had significantly lower peak serum direct and total bilirubin levels, and a lower incidence of neonatal cholestasis compared to those without UDCA treatment.

Article Abstract

Background: Preterm infants with long-term parenteral nutrition (PN) therapy are at risk for cholestasis associated with total parenteral nutrition (PNAC). This study examined the safety and efficacy of ursodeoxycholic acid (UDCA) in preventing PNAC in preterm infants. Our research aimed to investigate the prophylactic effect of preventive oral UDCA on PNAC in preterm infants.

Methods: We compared oral administration of UDCA prophylaxis with no prophylaxis in a randomized, open-label, proof-of-concept trial in preterm neonates with PN therapy. The low-birth-weight preterm infants (< 1800 g) who were registered to the neonatal intensive care unit (NICU) within 24 hours after birth were randomized. The main endpoint was the weekly values of direct bilirubin (DB) of neonates during the NICU stay.

Results: Eventually, a total of 102 preterm neonates from January 2021 to July 2021 were enrolled in this prospective study (42 in the UDCA group and 60 in the control group). Notably, the peak serum level of DB [13.0 (12-16) vs. 15.2 (12.5-19.6) μmol/L, P < 0.05)] was significantly lower in the UDCA group than that in the control group without prevention. The peak serum level of total bilirubin (101.1 ± 34 vs. 116.5 ± 28.7 μmol/L, P < 0.05) was also significantly lower in the UDCA group than in the control group. Furthermore, the proportion of patients who suffered from neonatal cholestasis (0.0% vs. 11.7%, P < 0.05) in the UDCA group was significantly lower.

Conclusion: UDCA prophylaxis is beneficial in preventing PNAC in NICU infants receiving prolonged PN.

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Source
http://dx.doi.org/10.1007/s12519-021-00487-0DOI Listing

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