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Hypertriglyceridemia and Intravenous Lipid Titration During Routine Parenteral Nutrition in Small Preterm Infants

Alessio Correani1, Ilaria Giretti1, Luca Antognoli1

  • 1Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona.

Journal of Pediatric Gastroenterology and Nutrition
|August 23, 2019
PubMed

Insights

Hypertriglyceridemia (HiTG) in preterm infants on parenteral nutrition (PN) did not impact growth or neurodevelopment, despite lower IV lipid intake. Strict triglyceride monitoring and lipid titration are safe for these infants.

Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Nutritional Science

Background:

  • Hypertriglyceridemia (HiTG) is a concern in preterm infants receiving parenteral nutrition (PN).
  • Current guidelines recommend intravenous (IV) lipid titration for HiTG, but its effects on preterm infants are not well understood.
  • This study investigates the outcomes of preterm infants experiencing HiTG during PN.

Purpose of the Study:

  • To compare macronutrient and energy intake, growth, prematurity-associated diseases, and neurodevelopment in preterm infants with and without HiTG on PN.
  • To assess the safety and consequences of IV lipid titration in small preterm infants with HiTG.

Main Methods:

  • Retrospective analysis of preterm infants (birth weight <1250g) receiving PN.
  • Infants with HiTG (triglyceride >250 mg/dL in first 10 days) were identified and matched with controls (CNTR) for birth weight and gestational age.
  • Data on nutrient intake, growth, diseases, and neurodevelopment were compared between groups.

Main Results:

  • 30% of infants developed HiTG; 136 HiTG infants were matched with 136 controls.
  • HiTG infants had significantly lower IV lipid, non-protein energy, and total energy intake in the first 10 days.
  • No significant differences were observed in diseases associated with prematurity, anthropometry at 36 weeks and 2-year corrected age, or neurodevelopment at 2-year corrected age.

Conclusions:

  • Preterm infants with HiTG on PN showed similar growth and neurodevelopmental outcomes compared to controls.
  • This similarity was achieved despite a slight reduction in IV lipid and energy intake due to vigilant triglyceride monitoring and lipid titration.
  • The findings suggest that current management strategies for HiTG in preterm infants are effective in preventing adverse long-term outcomes.
Abstract

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