ปัจจัยเสี่ยงต่อการเกิดภาวะน้ำดีคั่งจากการได้รับสารอาหารทางหลอดเลือดในทารกแรกเกิด ณ โรงพยาบาลนครพิงค์

Abstract

The objective of this research were to study the risk factors of parenteral nutrition-associated cholestasis (PNAC) at Nakornping hospital. This study enrolled infants who were admitted to our neonatal intensive care unit and treated with parenteral nutrition (PN) infusion for at least 14 days between August 2009 and April 2014. Multiple possible risk factors were analyzed by a retrospective cohort study design. Data were collected from SSB computer program, inpatient medical records and PN compounding computer program of Nakornping hospital. A total of 212 infants with prolonged course of PN were eligible for inclusion criteria in this study; 51 (24.06 %) of the infants developed PNAC. Infant with PNAC and without PNAC were significant differences in factors of duration of PN, age of initial gastrointestinal feeding (GI), lipid started date, lipid duration, average energy intake the 3rd week of life, total glucose intake, total energy intake from glucose, average AA intake, total AA intake, total energy intake from AA, total lipid intake and total energy intake from lipid. Of these risk factors which initial feeding and average energy intake at the 3rd week of life was most significant after backward multivariable logistic regression analysis

Age of initial GI feeding and average energy intake at the 3rd week of life was most significant after backward multivariable logistic regression analysis. Although duration of PN was not statistically significant but most clinically significant risk factor in many previous studies and when analyzed with ROC Curve which can predict the development of PNAC for 77.10 %. Therefore if we aim to decrease the risk of PNAC in neonate who received PN at Nakornping hospital, we must decrease duration of PN, early initial GI feeding and reduce average energy intake at the 3rd week of life.