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Manufacture of Concentrated, Lipid-based Oxygen Microbubble Emulsions by High Shear Homogenization and Serial Concentration
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Intravenous Lipid Emulsions in Infants: Is Balanced Better?

Sara E Rostas, Christopher McPherson

    Neonatal Network : NN
    |January 26, 2019
    PubMed

    Insights

    Extremely preterm infants needing parenteral nutrition (PN) risk liver issues like PNAC/IFALD. Novel lipid emulsions with omega-3s may offer protection, but require further study before infant use.

    Area of Science:

    • Neonatalogy
    • Pediatric Gastroenterology
    • Nutritional Science

    Background:

    • Parenteral nutrition (PN) is essential for extremely preterm infants with gastrointestinal issues.
    • Prolonged PN can lead to parenteral nutrition-associated cholestasis (PNAC) and intestinal failure-associated liver disease (IFALD).
    • Current plant-based lipid emulsions may exacerbate PNAC/IFALD and other comorbidities due to omega-6 fatty acids and phytosterols.

    Purpose of the Study:

    • To evaluate the potential of alternative intravenous lipid emulsions in preventing PNAC/IFALD in preterm infants.
    • To assess the benefits of lipid emulsions with a favorable omega-6:omega-3 ratio, such as SMOFlipid.
    • To review existing data supporting the use of SMOFlipid in neonatal intensive care.

    Main Methods:

    • Review of existing literature on intravenous lipid emulsions in preterm infants.
    • Analysis of the composition of plant-based vs. animal-based lipid emulsions.
    • Examination of clinical data regarding PNAC/IFALD development and progression.

    Main Results:

    • Plant-based lipid emulsions contain proinflammatory omega-6 fatty acids and phytosterols.
    • Animal-based lipid emulsions, rich in omega-3 fatty acids and antioxidants, may be less inflammatory.
    • SMOFlipid, a mixed emulsion, has a favorable omega-6:omega-3 ratio, potentially mitigating liver disease.

    Conclusions:

    • Alternative lipid emulsions with balanced fatty acid profiles may prevent PNAC/IFALD in preterm infants.
    • SMOFlipid shows promise but requires thorough data review before widespread neonatal use.
    • Further research is crucial to confirm the safety and efficacy of novel lipid emulsions in vulnerable infant populations.

    Keywords:
    SMOFlipidinfantintestinal failure-associated liver diseaseintravenous lipid emulsionnutritionparenteral nutrition-associated cholestasis

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