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Hypertriglyceridaemia in extremely preterm infants receiving parenteral lipid emulsions
Ruth Sinclair1, Tim Schindler1,2, Kei Lui1,2
1Royal Hospital for Women, Randwick, NSW, Australia.
BMC Pediatrics
|November 9, 2018
Summary
Hypertriglyceridemia is common in preterm infants receiving parenteral lipid emulsions. Monitoring and adjusting lipid intake can mitigate potential consequences.
Area of Science:
- Neonatal Medicine
- Clinical Nutrition
- Pediatric Critical Care
Background:
- Parenteral nutrition in neonates frequently includes lipid emulsions (LE).
- Clinical practices for monitoring plasma triglycerides during LE therapy vary widely.
- Hypertriglyceridemia is a potential concern in this vulnerable population.
Purpose of the Study:
- To evaluate the incidence of hypertriglyceridemia (Plasma triglyceride > 2.8 mmol/L) in extremely preterm infants.
- To assess the association between hypertriglyceridemia and mortality or major morbidities.
- To inform clinical practice regarding LE administration in neonates.
Main Methods:
- Retrospective review of 195 infants < 29 weeks gestation.
- Standardized LE administration protocol with stepwise increase and triglyceride monitoring.
- Dosage adjustment to maintain plasma triglycerides ≤ 2.8 mmol/L.
Main Results:
- Hypertriglyceridemia occurred in 32.5% of infants aged 23-25 weeks and 16.1% aged 26-28 weeks.
- Severe hypertriglyceridemia (> 4.5 mmol/L) was observed in 10.0% and 4.5% of the respective groups.
- Univariate analysis suggested associations with mortality and retinopathy of prematurity, which were non-significant in multivariate analysis.
Conclusions:
- Hypertriglyceridemia is a frequent complication in extremely preterm infants on parenteral lipid emulsions.
- Regular monitoring and prompt adjustment of lipid emulsion dosage are crucial.
- Minimizing exposure to hypertriglyceridemia may help mitigate adverse outcomes.
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