Bmurbati

the TPN related cholestasis is common in long term TPN, however it ca be delayed if the TPN used carefully, it is unlikely to see cholestatic jaundice before 4-6weeks of starting TPN. but if you are careful it can be delayed for 6 and even 12 months after initiating the TPN and this is few tips to decrease the risk like -- 1- give cyclic TPN 2- alternative days lipids 3- protein not to exceeds 2.5g/kg/day 4- recurrent sepsis increase the risk of choestasis 4- start the treatment early as mentioned by Stefan Johansson