Children who cannot eat on their own because of intestinal failure must rely on parenteral nutrition (PN), an intravenous method of feeding. Unfortunately, long-term PN can cause life-threatening liver disease, especially in infants, for reasons that have been unknown. Many infants who develop this complication die within a year of diagnosis, unless they can be weaned off PN or receive a liver/small intestine transplant. In the July issue of Pediatrics, researchers at Children's Hospital Boston report saving two babies' lives with one able to come off a liver-transplant list simply by changing the type of fat used in the PN solution.
The story began in 2001 when, seeking to understand why PN was causing liver disease, surgeon Mark Puder, MD, surgical resident Jenna Garza, MD, and pharmacist Kathy Gura, PharmD, decided to conduct studies in mice. They found evidence that the fat used in standard PN solutions, called Intralipid, was contributing to liver disease by causing fat to accumulate in the liver.
Made largely of soybean oil, Intralipid is high in omega-6 fatty acids that are known to have an inflammatory effect. Puder's team decided to substitute OmegavenTM, an IV fat mixture made from fish oil. Fish oil contains omega-3 fatty acids, which have been shown to prevent fat accumulation and have anti-inflammatory properties. As hoped, PN using Omegaven as the fat prevented fat accumulation and liver injury in the mice.
Surgeon Rusty Jennings, MD, who directs Children's Advanced Fetal Care Center, had heard of Puder's research and wanted to try Omegaven in one of his patients, a 5-month-old patient born with gastroschisis, a life-threatening congenital defect in which the intestines develop outside the body. The surgeons had only been able to save a small portion of the boy's bowel, so he was unable to feed normally and was put on standard PN. He soon developed such serious liver damage that Jennings placed him on a tra
'"/>
Contact: Aaron Patnode
aaron.patnode@childrens.harvard.edu
617-355-6420
Children's Hospital Boston
3-Jul-2006
Page: 1 2 Related medicine news :1.
Postpartum hospital discharges -- when is the right time?2.
AASM to school-bound: Sleep is the right ingredient for academic success3.
Brightening prospects of using fluorescent nanotubes in medical applications4.
Groundbreaking principles on sexual orientation and human rights released5.
Professors named Fulbright scholars6.
Do we need a world health insurance to realize the right to health?7.
Surveys find outright hunger among Latino immigrants in North Carolina8.
Human rights abuses frequent in Haitis capital9.
Childrens health and human rights are at risk in Nepal10.
More effort needed to prevent human rights abuses11.
Rheumatoid arthritis can be prevented if the timing is right