Related Experiment Video

Updated: Nov 18, 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

11.0K

Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates

Gregory Guthrie1, Douglas Burrin1

  • 1USDA/ARS Children's Nutrition Research Center, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.

Nutrients
|February 9, 2021
PubMed

Insights

Total parenteral nutrition (TPN) can cause liver injury (PNAC) in infants. New fish oil and medium-chain triglyceride lipid emulsions may reduce this risk, offering a promising alternative for infant nutrition.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Nutritional Science

Background:

  • Total parenteral nutrition (TPN) is essential for infants unable to feed orally.
  • Prolonged TPN increases the risk of liver injury, specifically parenteral nutrition-associated cholestasis (PNAC).
  • Lipid emulsions in TPN are implicated in PNAC development, influenced by fatty acids, vitamin E, and phytosterols.

Purpose of the Study:

  • To review clinical studies on fish oil and medium-chain triglyceride (MCT) lipid emulsions for preventing PNAC in infants.
  • To examine current lipid emulsion constituents that may influence PNAC prevalence.
  • To explore novel TPN supplements for further PNAC incidence reduction.

Main Methods:

  • Literature review of clinical studies.
  • Analysis of lipid emulsion composition and its impact on PNAC.
  • Exploration of emerging TPN supplement strategies.

Main Results:

  • Fish oil and MCT-containing emulsions show potential in mitigating PNAC.
  • Specific lipid components (fatty acids, vitamin E, phytosterols) are key modulators of PNAC.
  • Further research into novel supplements is warranted.

Conclusions:

  • Novel lipid emulsions offer a promising approach to reduce PNAC in infants on TPN.
  • Understanding lipid composition is crucial for preventing TPN-associated liver injury.
  • Continued investigation into TPN strategies is vital for improving infant outcomes.

Keywords:
fish oillipid emulsionsmedium chain triglyceridesolive oilparenteral nutrition associated liver diseasepreterm infantssoybean oilvitamin E

More Related Videos

Isolation of Neonatal Extrahepatic Cholangiocytes07:54

Isolation of Neonatal Extrahepatic Cholangiocytes

Published on: June 5, 2014

10.6K
A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development08:50

A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development

Published on: June 24, 2020

4.0K

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,...
127
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...
89
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...
102
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
105
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...
2.7K
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
77