Aluminum is a known contaminant of parenteral nutrition (PN) solutions and it has been suspected to play a role in the development of parenteral nutrition associated cholestasis (PNAC). The primary purpose of my research was to monitor the relationship between serum aluminum level and the development of PNAC in the infants with gastrointestinal failure who required PN therapy. The secondary purpose was to develop a neonatal piglet model to compare different doses of aluminum or PN therapy with known aluminum level was associated with the development of PNAC.
Sixteen infants with gastrointestinal pathology were enrolled in the study. Serum aluminum and bilirubin (direct and indirect) concentrations were determined on day 0, 7, 14, and 21 of PN therapy. Five of sixteen (31.3%) infants developed PNAC by day 21. Serum aluminum levels in infants receiving PN peaked at day 7 of therapy and declined thereafter. There was no direct correlation between serum direct bilirubin and serum aluminum levels.
Twenty-four piglets, 2 to 4 days old, were placed into four groups: Control group (n=5); Low Al (aluminum) group (n=7), intravenous (iv) injection with aluminum dose at 20 ìgkg-1day-1; High Al (aluminum) group (n=6), iv with aluminum dose at 1500 ìgkg-1day-1; PN (parenteral nutrition) group (n=6), PN solutions with a mean aluminum intake at 37.8±14.3 ìgkg-1day-1. The experiment period was 21 days. Serum bilirubin was significantly (p<0.05) elevated in the High Al and PN groups. Liver aluminum concentration was significantly (p<0.05) elevated in all the experimental groups and the relationship was dose dependant. Serum, and urine concentrations of aluminum were significantly (p<0.05) elevated in High Al but not the Low Al and PN groups. Serum aluminum concentration was not correlated with serum total bilirubin levels.
Cholestasis developed by 21 days in five infants and in the piglets of two experimental groups (the High Al group and the PN group). High dose injection of aluminum may play a role in the development of PNAC in the neonatal piglets. The impact of aluminum may depend on the amount of pareternal aluminum intake and the presence of other potential factors such as lack of enternal feeding and individual physiological abilities.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:SSU.etd-08082005-112202 |
| Date | 15 August 2005 |
| Creators | Li, Mei |
| Contributors | Zello, Gordon A., Paterson, Phyllis G., Miller, Grant G., Lehotay, Denis C., Bruce, Garth A. |
| Publisher | University of Saskatchewan |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://library.usask.ca/theses/available/etd-08082005-112202/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Saskatchewan or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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