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One-year Experience With Composite Intravenous Lipid Emulsion in Children on Home Parenteral Nutrition

Bram P Raphael1, Paul D Mitchell2, Alexandra Carey1

  • 1Division of Gastroenterology, Hepatology and Nutrition.

Journal of Pediatric Gastroenterology and Nutrition
|December 2, 2020
PubMed

Insights

Composite lipid emulsion (CLE) is safe for children on home parenteral nutrition (HPN). This study found CLE reduced glucose infusion rates and improved fatty acid profiles without adverse events in pediatric patients.

Area of Science:

  • Pediatric Nutrition
  • Intravenous Lipid Emulsions
  • Gastroenterology

Background:

  • Composite lipid emulsion (CLE) is FDA-approved for adults requiring parenteral nutrition.
  • CLE offers theoretical advantages for pediatric patients on home parenteral nutrition (HPN) without cholestasis, including reduced phytosterol exposure and omega-3 supplementation.

Purpose of the Study:

  • To evaluate the safety and efficacy of CLE in pediatric patients (<18 years) on HPN.
  • To assess changes in anthropometrics, glucose infusion rates (GIRs), fatty acid profiles, and liver function tests over 12 months.

Main Methods:

  • Prospective, single-center, open-label study.
  • 57 pediatric patients on HPN received CLE (1-3 g/kg/day) for 12 months.
  • Primary outcomes: changes in anthropometrics and GIRs; Secondary outcomes: fatty acid profiles and liver function.

Main Results:

  • Mean GIRs decreased from 17 to 14 mg/kg/h at 4-6 months postbaseline.
  • Stable growth parameters and a decline in mean arachidonic acid levels were observed.
  • No significant adverse events were reported during the 12-month study period.

Conclusions:

  • Composite lipid emulsion (CLE) is safe and well-tolerated in stable pediatric patients on home parenteral nutrition (HPN) for up to one year.
  • Further research is warranted to determine long-term outcomes in this population.
Abstract

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