Parenteral Nutrition-Associated Liver Disease in Adult Inpatients Receiving Commercial Premixed Parenteral Nutrition for More Than 2 Weeks

Abstract

Background Long-term use of parenteral nutrition (PN) may elicit complications, including PN-associated liver disease (PNALD), which may yield critical outcomes. This study intended to investigate the development of complications associated with commercial premixed PN in adult patients. Methods Adult patients who received nutrition support with commercial PN without enteral intake for >14 consecutive admission days were included in the analysis. Results Seventy-two adults, from 2001 to 2016, were reviewed. Mean length of hospital stay was 43.0 days. A mean of 27.3 days of PN was given. Mean energy supplied by PN was 29 kcal/kg/d. Ten patients (13.8%) developed PNALD. Length of stay was significantly longer (P= .034), and duration of PN administration was significantly longer (P= .022) in patients who developed PNALD. The proportion of PN products with soybean oil-based lipids was significantly higher, and fish oil- or medium-chain triglyceride-containing combination lipids were significantly lower in the patient group with PNALD (P= .02). Multivariate logistic regression analysis showed that longer duration of days receiving PN support was an independent risk factor for PNALD (odds ratio, 1.052;P= .029). Conclusion : The incidence of PNALD in hospitalized adult patients who received daily PN support with commercial premixed 3-in-1 products for >2 weeks was 13.8%. Longer duration of days receiving PN support was an independent risk factor for PNALD.