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.

Long-Term Fish Oil Lipid Emulsion Use in Children With Intestinal Failure–Associated Liver Disease

2016 ◽  
Vol 41 (6) ◽  
pp. 930-937 ◽  
Author(s):  
Prathima Nandivada ◽  
Gillian L. Fell ◽  
Paul D. Mitchell ◽  
Alexis K. Potemkin ◽  
Alison A. O’Loughlin ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fish Oil ◽  
Lipid Emulsion ◽  
Intestinal Failure

Very Low Birth Weight Outcomes

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 357-357
Author(s):  
HELEN HARRISON
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Meta Analysis ◽  
Low Birth Weight Infants ◽  
Randomized Controlled Clinical Trials ◽  
Weight Outcomes ◽  
Term Evaluation

To the Editor.— The authors of the National Institute of Child Health and Human Development report on neonatal care1 found "important" variations among neonatal intensive care units in philosophies of treatment, methods of treatment, and short-term outcomes. In a recent meta-analysis of follow-up studies,2 researchers document a similarly haphazard approach to the long-term evaluation of very low birth weight survivors. Until randomized controlled clinical trials validate the safety and efficacy of neonatal therapies, and until long-term outcomes are assessed accurately, the treatment of very low birth weight infants should be declared experimental.

scholarly journals Short- and long-term outcomes of very low birth weight infants in Korea: Korean Neonatal Network update in 2019

2020 ◽  
Vol 63 (8) ◽  
pp. 284-290 ◽  
Author(s):  
Jang Hoon Lee ◽  
YoungAh Youn ◽  
Yun Sil Chang ◽  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Annual Reports ◽  
Long Term Outcomes ◽  
Post Discharge ◽  
Low Birth Weight Infants ◽  
Korean Society

Korea currently has the world’s lowest birth rate but a rapidly inreasing number of preterm infants. The Korean Neonatal Network (KNN), launched by the Korean Society of Neonatology under the support of Korea Centers for Disease Control, has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. In terms of the short-term outcomes of VLBWIs born from 2013 to 2016 registered in the KNN, the survival rate of all VLBWIs was 86%. Respiratory distress syndrome and bronchopulmonary dysplasia were observed in 78% and 30% of all VLBWIs, respectively. Necrotizing enterocolitis occurred in 7%, while 8% of the VLBWIs needed therapy for retinopathy of prematurity in the neonatal intensive care unit (NICU). Sepsis occurred in 21% during their NICU stay. Intraventricular hemorrhage (grade ≥III) was diagnosed in 10%. In terms of the long-term outcomes for VLBWIs born from 2013 to 2014 registered in the KNN, the post-discharge mortality rate was approximately 1.2%–1.5%, mainly owing to their underlying illness. Nearly half of the VLBWIs were readmitted to the hospital at least once in their first 1–2 years of life, mostly as a result of respiratory diseases. The overall prevalence of cerebral palsy was 6.2%–6.6% in Korea. Bilateral blindness was reported in 0.2%–0.3% of VLBWIs, while bilateral hearing loss was found in 0.8%–1.9%. Since its establishment, the KNN has published annual reports and papers that facilitate the improvement of VLBWI outcome and the formulation of essential healthcare policies in Korea.

scholarly journals Intravenous fish oil lipid emulsion promotes a shift toward anti-inflammatory proresolving lipid mediators

2013 ◽  
Vol 305 (11) ◽  
pp. G818-G828 ◽  
Author(s):  
Brian T. Kalish ◽  
Hau D. Le ◽  
Jonathan M. Fitzgerald ◽  
Samantha Wang ◽  
Kyle Seamon ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fish Oil ◽  
Lipid Emulsion ◽  
Lipid Mediators ◽  
Lipid Emulsions ◽  
Serum Samples ◽  
Human Infants ◽  
Life Threatening ◽  
Small Cohort ◽  
Anti Inflammatory

Parenteral nutrition (PN)-associated liver disease (PNALD) is a life-threatening complication of the administration of PN. The development of PNALD may be partly due to the composition of the lipid emulsion administered with PN: soybean oil-based lipid emulsions (SOLE) are associated with liver disease, while fish oil-based lipid emulsions (FOLE) are associated with prevention and improvement of liver disease. The objective of this study was to determine how the choice of lipid emulsion modified the production of bioactive lipid mediators (LMs). We utilized a mouse model of steatosis to study the differential effect of FOLE and SOLE. We subsequently validated these results in serum samples from a small cohort of human infants transitioning from SOLE to FOLE. In mice, FOLE was associated with production of anti-inflammatory, proresolving LMs; SOLE was associated with increased production of inflammatory LMs. In human infants, the transition from SOLE to FOLE was associated with a shift toward a proresolving lipidome. Together, these results demonstrate that the composition of the lipid emulsion directly modifies inflammatory homeostasis.

scholarly journals Liver Disease Secondary to Intestinal Failure

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Bassam Abu-Wasel ◽  
Michele Molinari
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Multidisciplinary Approach ◽  
Intestinal Failure ◽  
Term Survival ◽  
Early Referral ◽  
Long Term Survival ◽  
Threatening Condition ◽  
Life Threatening

IFALD is a common and potentially life-threatening condition for patients with SBS requiring long-term PN. There exists the potential for decreasing its incidence by optimizing the composition and the rate of infusion of parenteral solutions, by advocating a multidisciplinary approach, and by early referral for intestinal-liver transplantation to ensure long-term survival of patients with SBS.

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