scholarly journals The Effect of Fish Oil-Based Lipid Emulsion and Soybean Oil-Based Lipid Emulsion on Cholestasis Associated with Long-Term Parenteral Nutrition in Premature Infants

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Leilei Wang ◽  
Jing Zhang ◽  
Jiejin Gao ◽  
Yan Qian ◽  
Ya Ling
Keyword(s):  
Birth Weight ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Soybean Oil ◽  
Premature Infants ◽  
Lipid Emulsion ◽  
Lipid Emulsions ◽  
Feeding Intolerance ◽  
Total Dosage

Purpose. To retrospectively study the effect of fish oil-based lipid emulsion and soybean oil-based lipid emulsion on cholestasis associated with long-term parenteral nutrition in premature infants.Methods. Soybean oil-based lipid emulsion and fish oil-based lipid emulsion had been applied in our neonatology department clinically between 2010 and 2014. There were 61 qualified premature infants included in this study and divided into two groups. Soybean oil group was made up of 32 premature infants, while fish oil group was made up of 29 premature infants. Analysis was made on the gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, age at which feeding began, usage of lipid emulsions, and incidence of cholestasis between the two groups.Results. There were no statistical differences in terms of gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, and age at which feeding began. Besides, total incidence of cholestasis was 21.3%, and the days of life of occurrence of cholestasis were53±5.0days. Incidence of cholestasis had no statistical difference in the two groups.Conclusion. This study did not find the different role of fish oil-based lipid emulsions and soybean oil-based lipid emulsions in cholestasis associated with long-term parenteral nutrition in premature infants.

scholarly journals Parenteral nutrition with fish oil-based lipid emulsion reduces the risk of cholestasis in preterm infants

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110118
Author(s):  
Yi-Ling Wang ◽  
Lih-Ju Chen ◽  
Lon-Yen Tsao ◽  
Hsiao-Neng Chen ◽  
Cheng-Han Lee ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Fish Oil ◽  
Soybean Oil ◽  
Preterm Infants ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Lipid Emulsion ◽  
Very Low Birth Weight ◽  
Lipid Emulsions

Objective Preterm infants receive long-term parenteral nutrition (PN) for gastrointestinal immaturity. This study aimed to determine if mixed lipid emulsions containing fish oil decrease the incidence of PN-associated cholestasis by reducing oxidative stress and providing an anti-inflammatory effect. Methods This retrospective cohort study enrolled 399 very low birth weight premature infants (gestational age ≤32 weeks) between January 2009 and November 2017 at a single neonatal intensive care unit. Preterm infants received total PN with either mixed lipid emulsion including fish oil (SMOFlipid®, n = 195) or soybean oil-based lipid emulsion (Lipovenoes®, n = 204) for at least 7 days. We compared the outcomes of PN-associated cholestasis, comorbidities, and mortality between the groups. Results The incidence of PN-associated cholestasis was significantly lower in the SMOFlipid group than in the Lipovenoes group. The duration to full feeding days was significantly shorter in the SMOFlipid group compared with the Lipovenoes group. Relevant complications, such as severe retinopathy of prematurity and bronchopulmonary dysplasia, were also significantly reduced in the SMOFlipid group compared with the Lipovenoes group. Conclusion In premature infants, PN with fish oil-based lipid emulsions is associated with a lower incidence of PN-associated cholestasis compared with soybean oil-based lipid emulsions.

scholarly journals Parenteral nutrition with fish oil-based lipid emulsion reduces the risk of cholestasis in preterm infants

2019 ◽  
Author(s):  
YI-LING WANG ◽  
Lih-Ju Chen ◽  
Lon-Yen Tsao ◽  
Hsiao-Neng Chen ◽  
Cheng-Han Lee ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Fish Oil ◽  
Soybean Oil ◽  
Preterm Infants ◽  
Premature Infants ◽  
Lipid Emulsion ◽  
Very Low Birth Weight ◽  
Clinical Laboratory ◽  
Group Versus ◽  
Lipid Emulsions

Abstract Background Preterm infants received long-term parenteral nutrition (PN) due to gastrointestinal immaturity. Mixed lipid emulsions composed of soybean oil, medium chain triglycerides (MCTs), olive oil, and fish oil, which have a relatively low ω-6: ω-3 ratio, may decrease the incidence of PN-associated cholestasis by reducing oxidative stress and providing an anti-inflammatory effect.Methods The retrospective cohort study enrolled a total 399 very low birth weight (VLBW) premature infants between January 2009 and November 2017 at a single neonatal intensive care unit. Preterm infants received total parenteral nutrition with either mixed lipid emulsion (SMOFlipid, n = 195) or soybean oil-based lipid emulsion (Lipovenoes, n = 204) for at least seven days. We compared the outcomes of PN-associated cholestasis, co-morbidities and mortality.Results The incidence of PN-associated cholestasis was significantly lower in the SMOFlipid group than the Lipovenoes group (10.3% vs 20.1%, P = 0.006). The related clinical laboratory findings, including levels of γ- GT (P = 0.019), triglyceride (P < 0.001), and cholesterol (P = 0.023), were significantly lower in the SMOFlipid group. The duration to full feeding days shortened in the SMOFlipid group compared with the Lipovenoes group (25 ± 10.33 vs 33 ± 16.22, P < 0.001). Relevant complications, such as severe retinopathy of prematurity (ROP, 3.6% vs 14.3%, P < 0.001) and bronchopulmonary dysplasia (BPD, 36.9% vs 46.7%, P = 0.046) were also reduced in the SMOFlipid group versus the Lipovenoes group, but there was no significant effect on severe intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), or mortality in both groups.Conclusions In very premature infants, PN with fish oil-based lipid emulsions is associated with a lower incidence of PN-associated cholestasis compared with soybean oil-based lipid emulsions.

scholarly journals Fish Oil Lipid Emulsion-Associated Sea-Blue Histiocyte Syndrome in a Pediatric Patient

2015 ◽  
Vol 20 (3) ◽  
pp. 217-221
Author(s):  
Ting Ting Wu ◽  
David S. Hoff
Keyword(s):  
Bone Marrow ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Soybean Oil ◽  
Total Parenteral Nutrition ◽  
Pediatric Patient ◽  
Lipid Emulsion

A syndrome of hepatosplenomegaly, thrombocytopenia, and anemia and the presence of sea-blue histiocytes in bone marrow has been associated with parenteral soybean oil administration in patients receiving long-term total parenteral nutrition (TPN). A case is described here where this syndrome was observed in a pediatric patient who received long-term parenteral fish oil nutrition.

scholarly journals Fish Oil Monotherapy for Intestinal Failure-Associated Liver Disease on SMOFlipid in the Neonatal Intensive Care Unit

2020 ◽  
Vol 9 (11) ◽  
pp. 3393
Author(s):  
Sanghoon Lee ◽  
Se In Sung ◽  
Hyo Jung Park ◽  
Yun Sil Chang ◽  
Won Soon Park ◽  
...  
Keyword(s):  
Liver Disease ◽  
Birth Weight ◽  
Fish Oil ◽  
Neonatal Intensive Care ◽  
Lipid Emulsion ◽  
Intestinal Failure ◽  
Direct Bilirubin ◽  
Low Birth Weight Infants ◽  
Life Threatening

Intestinal failure-associated liver disease (IFALD) is a life-threatening complication of parenteral nutrition (PN) and is most prevalent in the preterm neonatal population receiving long-term PN. In this study, we report the outcome of our experience with fish oil monotherapy for IFALD in a fish oil-based combination lipid emulsion administered to preterm low birth weight infants. Fasting neonates were administered as PN according to our center’s nutrition protocol. A diagnosis of IFALD was made when the serum direct bilirubin levels were >2.0 mg/dL in two consecutive measurements that were more than one week apart, without evidence of intrinsic causes of liver dysfunction. The management of IFALD was conducted by switching the lipid emulsion from combination lipid emulsion to fish oil monotherapy at 1.0 g/kg/day, infused over 24 h. Fifteen infants met the criteria for IFALD and received fish oil monotherapy. The median gestational age was 27.5 weeks and the median birth weight was 862.5 g. IFALD was successfully reversed in 11 infants (11/15, 73.3%). The median duration of fish oil monotherapy was 39 days. Direct bilirubin values were initially elevated and then steadily declined from the third week of treatment onward. The enteral tolerance increased in varying degrees during the treatment period. The mean weight gain was 26.0 g/day during fish oil monotherapy. Omegaven® (Fresenius Kabi Austria Gmbh, Graz, Austria) at a dose of 1.0 g/kg/day was well tolerated, and no adverse events related to Omegaven use were seen. The reversal of IFALD in preterm infants on combination lipid emulsion containing fish oil was achieved by switching to fish oil monotherapy.

scholarly journals A Retrospective Analysis of the Effect of Combination of Pure Fish Oil with Third Generation Lipid Emulsion on Liver Function in Children on Long-Term Parenteral Nutrition

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2495
Author(s):  
Mikołaj Danko ◽  
Aleksandra Żyła-Pawlak ◽  
Janusz Książyk ◽  
Katarzyna Olszewska-Durkacz ◽  
Marta Sibilska ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Retrospective Analysis ◽  
Lipid Emulsion ◽  
Intestinal Failure ◽  
Third Generation ◽  
Glutamyl Transferase

Background: Deterioration of liver function, or intestinal failure-associated liver disease, is often observed in long-term parenterally fed children. Fish oil-based intravenous lipids have been reported to play a role in the prevention and treatment of intestinal failure associated liver disease. Methods: This retrospective analysis included 40 pediatric patients, (20 male and 20 female), median age 38 months (range 1.5–200 months) on long-term (≥1 month) parenteral nutrition who received the parenteral mixtures containing a combination of a third-generation lipid emulsion and pure fish oil because of laboratory liver function abnormalities. The total dose of fish oil from both emulsions for each patient exceeded 0.5 g/kg/day. Data from visits in an outpatient clinic were retrospectively analyzed using the Wilcoxon test, Mann-Whitney test, and Spearman correlation test. Results: The median time of therapy was 149 days (range 28–418 days). There was a decrease of median total and direct (conjugated) bilirubin concentration from 22.23 µmol/L (range 3.42–243 µmol/L) to 10.26 µmol/L (range 3.42–180.58 µmol/L; p < 0.005) and 8.55 (range 1.71–212.04 µmol/L) to 6.84 µmol/L (range 1.71–150.48 µmol/L; p < 0.007) respectively. A significant decrease in median alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase was also observed. In 11 patients bilirubin concentrations increased or remained unchanged. When compared to the patients who responded to the combination therapy, the patients who did not respond received parenteral nutrition for a longer time prior to the start of the therapy (51 vs. 30 months; p < 0.05). Conclusions: The mixture of an intravenous lipid emulsion containing soybean oil, medium-chain triglycerides, olive oil, and fish oil with the addition of pure fish oil emulsion may be helpful in the treatment of liver complications in children on long-term parenteral nutrition.

Morbidity Outcomes of Very Low Birth Weight Neonates Receiving Parenteral Nutrition with Fish Oil Enriched Lipid Emulsion or Lipid Emulsion with Soybean Oil: An Observational Study

2020 ◽  
Author(s):  
José Uberos ◽  
Sara Jiménez-Montilla ◽  
Manuel Molina-Oya ◽  
Pelayo Nieto-Gómez ◽  
Isabel Cubero Millan
Keyword(s):  
Birth Weight ◽  
Vitamin E ◽  
Low Birth Weight ◽  
Observational Study ◽  
Parenteral Nutrition ◽  
Soybean Oil ◽  
Lipid Emulsion ◽  
Very Low Birth Weight ◽  
Alternative Formulation ◽  
Oil Composition

AbstractIntralipid (Fresenius Kabi) was the most commonly used lipid emulsion in parenteral nutrition (PN), with a 100% soybean oil composition, a low vitamin E content, and a ω-6: ω-3 ratio of 7:1. A recent alternative formulation is SMOFlipid (Fresenius Kabi), with a ω-6: ω-3 ratio of 5:2 and higher vitamin E content. A retrospective observational study was conducted to determine neonatal morbidity in very low birth weight (VLBW) premature infants during two periods: P1, when PN was based exclusively on Intralipid, and P2, when only SMOFlipid was supplied. In total, 170 VLBW neonates were analyzed, of whom 103 received PN for more than 6 days, 56 during P1, and 47 during P2. In both periods, the antenatal and neonatal characteristics of the cohort were comparable. In this analysis, the prevalence of associated comorbidities was determined. During P2, there were fewer cases of moderate to severe bronchopulmonary dysplasia (BPD) and of cholestasis, but more cases of late sepsis, mainly Staphylococcus epidermidis. No changes in the prevalence of other neonatal comorbidities were observed. We believe that the SMOFlipid used in PN could discreetly improve the prevalence of cholestasis or BPD.

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