Q: The cutoff point to hold copper and manganese in total parenteral nutrition (TPN) in ICU patients with cholestasis is?
A) total bilirubin of 2
B) total bilirubin of 3
C) total bilirubin of 4
D) total bilirubin of 5
E) It depends on liver transaminases
Answer: A
A large number of patients in ICU receive TPN, but 'one size does not fit all'. It is frequently required to alter the prescription of TPN depending on underlying clinical situations and labs. Copper and manganese get excreted via bile. They should be held off in patients where suspicion of cholestasis arises. Total bilirubin (TB) of 2 mg/dl is considered a cut off for this purpose.
#nutrition
#hepatology
Reference:
Jin J, Mulesa L, Carrilero Rouillet M. Trace Elements in Parenteral Nutrition: Considerations for the Prescribing Clinician. Nutrients. 2017;9(5):440. Published 2017 Apr 28. doi:10.3390/nu9050440
A) total bilirubin of 2
B) total bilirubin of 3
C) total bilirubin of 4
D) total bilirubin of 5
E) It depends on liver transaminases
Answer: A
A large number of patients in ICU receive TPN, but 'one size does not fit all'. It is frequently required to alter the prescription of TPN depending on underlying clinical situations and labs. Copper and manganese get excreted via bile. They should be held off in patients where suspicion of cholestasis arises. Total bilirubin (TB) of 2 mg/dl is considered a cut off for this purpose.
#nutrition
#hepatology
Reference:
Jin J, Mulesa L, Carrilero Rouillet M. Trace Elements in Parenteral Nutrition: Considerations for the Prescribing Clinician. Nutrients. 2017;9(5):440. Published 2017 Apr 28. doi:10.3390/nu9050440
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