Randomized control study of two different parenteral nutrition strategies on liver fuction of very low birth weight infants

Objective To explore the effects of two different parenteral nutrition(PN)treatments(conservative and active)on the liver function of very low birth weight infant(VLBWI). Methods The VLBWIs were randomly divided into low PN(n=75)and high PN groups(n=71)hospitalized from March 2008 to March 2013.The low PN treatment was defined as:amino acids and fat emulsion started with a dosage of 0.5~1.0g/(kg·d),increased 0.5~1.0g/(kg·d)up to a sufficient amount of 3g/(kg·d);glucose infusion rate started from 4mg/(kg·min),increased 1mg/(kg·min)per day,up to a maximum of 12mg/(kg·min).The high PN group was defined as:amino acid started from 1.5~2.0g/(kg·d)then increased1.0g/(kg·d)up to a sufficient amount of 3.5~4.0g/(kg·d),fat emulsion started from 1.0g/(kg·d)then increased1.0g/(kg·d)up to a sufficient amount of 3.0g/(kg·d)and glucose infusion rate started from 6mg/(kg·min)then increased 2mg/(kg·min)per day up to a maximum of 12mg/(kg·min).The enteral feeding and growth index were recorded.Liver function was measured. Results Compared with high PN group,the PN duration in low PN group lasted longer,the time for calorie of enteral feeding to reach 90kcal/(kg·d)and the time for birth weight catch-up were longer in low PN group(P0.05).The primary biochemical markers of 7th,14 th and 28th~42th day were similar in the two groups(P0.05).No statistically significant difference was observed in the incidence of PN-associated cholestasis(PNAC)between the two groups(P0.05).The hospitalization days were similar in the two groups(P0.05).The hospitalization fee in the high PN group was less than that in the low PN group(P0.05). Conclusion High PN do not affect the liver function or increase the incidence of PNAC in VLBWI.