소아 조혈모세포 이식 환자의 TPN 사용에 대한 평가 = Total Parenteral Nutrition and Nutritional Use Evaluation in Pediatric Hematopoietic Stem Cell Transplantation

다국어 초록 (Multilingual Abstract)

To evaluate the usage of total parenteral nutrition(TPN) and to assess the nutritional benefits ad risks of TPN in pediatric hematopoietic stem cell transplantation, 52 pediatric patients who received hematopoietic stem cell transplantation were studied retrospectively. Each patient was monitored until TPN was discontinued or for a maximum of 21days. The mean daily energy intake given intravenously was 80.6±23.3% of basal metabolic rate(BMR) and protein intake was 1.07±0.49g/㎏/d(mean±S.D.). Weight did not present statistically significant variations. Serum albumin levels fell markedly on day 7(3.47±0.34g/dL), but returned to normal on day 14(3.71±0.34g/dL) and then keep up to day 21. Total protein levels were significantly increased on days 7, 14, 21. Blood glucose levels significantly rose from day 14. In metabolic complication, the most frequent abnormalities were hypomagnesemia(65.4%). Blood urea nitrogen(BUN) was below normal on day 0(7.12±3.47㎎/dL) and significantly rose during TPN(11.58±6.87㎎/dL on day 7). Serum creatinine levels significantly decreased on day 14. Transaminases were moderately elevated at the start of TPN, but returned to normal on day 7. Total bilirubin and alkaline phosphatase(ALP) were normal during TPN, with slight fluctuation, always in the normal range. Nutritional support with TPN was effective in maintaining weight and viceral proteins. It is need to close monitoring during TPN in pediatric hematopoietic stem cell transplantation.