This is a retrospective analysis of medical records of all VLBW infants admitted to the neonatal intensive care unit (NICU) at King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, between January 2001 and December 2003. Excluded were infants who had significant congenital malformations, died in the first 10 days of life or had other confirmed causes of cholestasis other than TPN-AC. Significant cholestatic jaundice was defined as direct serum bilirubin > 34 μmol/L. TPN formula used during the study period was Vaminolact (Fresenius Kabi, Homburg, Germany). The components of TPN were adjusted and individualized according to the patient's clinical condition. A total of 3 g/kg/day of amino acids and 3 g/kg/day of intralipid were infused continuously over 24 h via peripheral or central line. For the sake of analysis, the patients were divided into two groups: Cholestasis and noncholestasis groups, based on the value of direct serum bilirubin.
The possible risk factors collected were gestational age (GA), birth weight (Bwt), gender, Apgar score (AS), TPN duration, age at initial feeding, age at full feeds, episodes of culture-confirmed sepsis, umbilical arterial and venous catheterization, bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), and necrotizing enterocolitis (NEC). Bacterial sepsis was defined as positive blood, cerebrospinal fluid, or urine culture. The age at initial feeding was defined as the age of the first enteral feed.
The possible risk factors collected were gestational age (GA), birth weight (Bwt), gender, Apgar score (AS), TPN duration, age at initial feeding, age at full feeds, episodes of culture-confirmed sepsis, umbilical arterial and venous catheterization, bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), and necrotizing enterocolitis (NEC). Bacterial sepsis was defined as positive blood, cerebrospinal fluid, or urine culture. The age at initial feeding was defined as the age of the first enteral feed.
