Hypertriglyceridaemia in extremely preterm infants receiving parenteral lipid emulsions

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Ruth Sinclair1, Tim Schindler1,2, Kei Lui1,2

  • 1Royal Hospital for Women, Randwick, NSW, Australia.

BMC Pediatrics
|November 9, 2018
PubMed

Insights

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.
Abstract

Keywords:
HypertriglyceridemiaLipid emulsionNeonatePreterm

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