Withholding Parenteral Nutrition During Critical Illness Increases Plasma Bilirubin but Lowers the Incidence of Biliary Sludge

Abstract

Tolerating substantial caloric deficit by withholding PN until day 8 of critical illness increased plasma bilirubin but reduced the occurrence of biliary sludge and lowered GGT, ALP, and ALT. These results suggest that hyperbilirubinemia during critical illness does not necessarily reflect cholestasis and instead may be an adaptive response that is suppressed by early PN.