Nowadays, the total parenteral nutrition (TPN) is widely used in intensive care unit (ICU) to provide a complete nutrition for patients with impossible oral food intake. The liver complications of this therapy is widely reported and the etiology is multifactorial, in particular it seems important the role of the hypercaloric infusion (especially with excess glucose). The epathic injuries reported in literature are steatosis, steatoepathitis, cholestasis, cholelithiasis. The necrosis is considered to be a consequence of preexhisting hepatic alterations. In order to analyze the liver complications of TPN we considered 16 autopsied cases with an hospitalisation of more than I week in ICU and without preexhisting hepatic injuries or multi organic failure syndrome (MOFS): eight received TPN, the control group was treated with enterai nutrition. The clinical history was analyzed considering some of the scores usually used in ICU (APACHE II, SIRS, SOFA, Goris). Histologically we analyzed the presence of macro and microvasicular steatosis, cholestasis, centrilobular or massive liver cell necrosis, perivenular sinusoid dilatation, portal inflammation, intranuclear glycogen accumulation, lipofuscin accumulation in liver cell and in Kupferr cell. The results were analyzed with mono and bivariate statistic, T-student test, χ 2, Mann-Withney test. The results showed an increase in cholestasis, perivenular sinusoidal dilatation and liver cell necrosis, in cases with no preexhisting hepatic injuries. Moreover the authors stress the medico-legal issue of choosing a therapy (the TPN) that can lead to so severe compications. © SINPE-GASAPE.

Di Paolo, M., Luchini, D., Del Vecchio, M.T., Scolletta, S., Giomarelli, P. (2005). Total parenteral nutrition (TPN)-induced histopathologic hepatic abnormalities. RIVISTA ITALIANA DI NUTRIZIONE PARENTERALE ED ENTERALE, 23(1), 10-17.

Total parenteral nutrition (TPN)-induced histopathologic hepatic abnormalities

Del Vecchio M. T.;Scolletta S.;Giomarelli P.
2005-01-01

Abstract

Nowadays, the total parenteral nutrition (TPN) is widely used in intensive care unit (ICU) to provide a complete nutrition for patients with impossible oral food intake. The liver complications of this therapy is widely reported and the etiology is multifactorial, in particular it seems important the role of the hypercaloric infusion (especially with excess glucose). The epathic injuries reported in literature are steatosis, steatoepathitis, cholestasis, cholelithiasis. The necrosis is considered to be a consequence of preexhisting hepatic alterations. In order to analyze the liver complications of TPN we considered 16 autopsied cases with an hospitalisation of more than I week in ICU and without preexhisting hepatic injuries or multi organic failure syndrome (MOFS): eight received TPN, the control group was treated with enterai nutrition. The clinical history was analyzed considering some of the scores usually used in ICU (APACHE II, SIRS, SOFA, Goris). Histologically we analyzed the presence of macro and microvasicular steatosis, cholestasis, centrilobular or massive liver cell necrosis, perivenular sinusoid dilatation, portal inflammation, intranuclear glycogen accumulation, lipofuscin accumulation in liver cell and in Kupferr cell. The results were analyzed with mono and bivariate statistic, T-student test, χ 2, Mann-Withney test. The results showed an increase in cholestasis, perivenular sinusoidal dilatation and liver cell necrosis, in cases with no preexhisting hepatic injuries. Moreover the authors stress the medico-legal issue of choosing a therapy (the TPN) that can lead to so severe compications. © SINPE-GASAPE.
2005
Di Paolo, M., Luchini, D., Del Vecchio, M.T., Scolletta, S., Giomarelli, P. (2005). Total parenteral nutrition (TPN)-induced histopathologic hepatic abnormalities. RIVISTA ITALIANA DI NUTRIZIONE PARENTERALE ED ENTERALE, 23(1), 10-17.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/1134495