Pediatric parenteral nutrition-associated XXXX and @entity1448 : Novel advances in pathomechanisms-based prevention and treatment.

@entity1 @entity32 @entity310 @entity409 @entity1474 @entity1448 @entity1460 @entity10055
UNASSIGNED: Parenteral nutrition constitutes a life-saving therapeutic tool in @entity1 unable to ingest/absorb oral or enteral delivered nutrients. Liver function tests abnormalities are a common therapy-related complication, thus configuring the so-called Parenteral Nutrition Associated @entity409 (PNALD) or @entity1448 (PNAC). Although the damage is frequently mild, and resolves after discontinuation of parenteral nutrition, in some cases it progresses into cirrhotic changes, especially in neonates and @entity1 . We present a literature review focusing on the pathogenetic mechanisms-driven prevention and therapies for the cases where parenteral nutrition cannot be discontinued. @entity10055 has been proposed in @entity1 with @entity1448 , but its efficacy needs to be better established. Little evidence is available on efficacy of anti-oxidants, antibiotics, probiotics and anti @entity310 . Lipid emulsions based on fish oil with a high content of long-chain @entity1474   -3 appear effective both in @entity32 and in improving biliary flow. Most recent promising variations such as @entity1460 /MCT/olive/fish oil emulsion [third generation lipid emulsion (SMOFlipid)] are under investigation. In conclusion, we remark the emergence of a number of novel pathomechanisms underlying the severe @entity409 (PNALD and PNAC) in @entity1 treated with parenteral nutrition. Only few traditional and innovative therapeutic strategies have hitherto been shown promising.
