Related Experiment Video

Updated: Dec 29, 2025

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
04:53

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Published on: September 20, 2019

11.1K

Development of Parenteral Nutrition-Associated Liver Disease and Other Adverse Effects in Neonates Receiving

Lindsey Stramara1, Lela Hernandez1, Barry T Bloom2

  • 1Wesley Children's Hospital, Wichita, Kansas, USA.

JPEN. Journal of Parenteral and Enteral Nutrition
|February 7, 2020
PubMed

Insights

A four-oil lipid emulsion (ILE) may help prevent parenteral nutrition-associated liver disease (PNALD) in neonates. This study found a lower incidence of PNALD in infants receiving the four-oil ILE compared to a soybean-oil ILE.

Area of Science:

  • Neonatal intensive care
  • Hepatology
  • Nutritional support

Background:

  • Parenteral nutrition-associated liver disease (PNALD) is a concern in neonates.
  • Intravenous lipid emulsions (ILEs) are a known risk factor for PNALD.
  • SMOFlipid, a four-oil ILE, is used for PNALD reversal, but its preventive role is unclear.

Purpose of the Study:

  • To evaluate the safety of a four-oil ILE in neonates.
  • To compare the effectiveness of a four-oil ILE versus a soybean-oil ILE in preventing PNALD.

Main Methods:

  • Observational, cohort, comparative safety study.
  • Matched 333 neonates receiving a four-oil ILE with 999 neonates receiving a soybean-oil ILE.
  • Primary outcome: incidence of PNALD (direct bilirubin > 2 mg/dL) after parenteral nutrition initiation.

Main Results:

  • PNALD occurred in 1.8% of the four-oil ILE group and 3.6% of the soybean-oil ILE group.
  • Relative risk for PNALD was 0.5 (95% CI, 0.21-1.18) for the four-oil ILE group.
  • No significant difference in PNALD incidence, but a trend towards reduced risk was observed.

Conclusions:

  • A four-oil ILE may possess a hepatoprotective effect in neonates.
  • Further research is warranted to confirm the preventive role of four-oil ILEs in PNALD.
  • This study suggests a potential benefit of four-oil ILEs in neonatal liver health.
Abstract

Keywords:
SMOFlipidlipidsliver diseaseneonatesparenteral nutrition

More Related Videos

Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers09:36

Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers

Published on: July 28, 2022

2.5K
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats07:36

Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats

Published on: November 20, 2015

11.7K

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
205
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
186
Factors Affecting Drug Response: Overview01:21

Factors Affecting Drug Response: Overview

When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.8K
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
147
Parentral Nutrition: Centeral and Peripheral Parental Nutrition01:27

Parentral Nutrition: Centeral and Peripheral Parental Nutrition

Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
625
Lipid Absorption01:24

Lipid Absorption

Dietary triglycerides from chyme in the duodenum are mixed with bile salts produced by the liver to emulsify fats. As a result, large droplets are broken down into smaller ones, increasing the surface area for enzymatic action. Once emulsified, pancreatic lipases hydrolyze the triglycerides into free fatty acids and monoglycerides.
These breakdown products bind with bile salts and lecithin to form micelles, which quickly pass between microvilli to come in close contact with the apical...
2.3K