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A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
Published on: September 20, 2019
[Clinical effect of multi-oil fat emulsion for parenteral nutrition support in extremely low birth weight infants]
Hui-Jia Lin1, Xiao-Xia Shen1, Ying-Hua Ni1
1Department of Neonatal Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine/National Clinical Research Center for Child Health, Hangzhou 310052, China.
Insights
Multi-oil fat emulsion (SMOF) did not reduce complications in extremely low birth weight (ELBW) infants. However, SMOF lessened the severity of parenteral nutrition-associated cholestasis (PNAC) compared to medium-chain/long-chain triglycerides (MCT/LCT) emulsions.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Intensive Care Medicine
Background:
- Parenteral nutrition (PN) is crucial for extremely low birth weight (ELBW) infants.
- Lipid emulsions are key components of PN, with various formulations available.
- Understanding the impact of different lipid emulsions on ELBW infant outcomes is essential.
Purpose of the Study:
- To evaluate the clinical efficacy of a multi-oil fat emulsion (soybean oil, medium-chain triglycerides, olive oil, and fish oil - SMOF) compared to a standard medium-chain/long-chain triglycerides (MCT/LCT) emulsion in ELBW infants receiving PN.
- To assess the incidence of various clinical complications and outcomes in ELBW infants based on the type of lipid emulsion used.
Main Methods:
- Retrospective analysis of 49 ELBW infants (≤14 days on admission, >14 days PN duration).
- Infants were divided into two groups: SMOF (n=26) and MCT/LCT (n=23).
- Comparison of clinical features, complications (including bronchopulmonary dysplasia, sepsis, necrotizing enterocolitis), nutrition support, and outcomes.
Main Results:
- No significant differences in the incidence of major complications like PDA, IVH, NEC, ROP, BPD, sepsis, or pneumonia between SMOF and MCT/LCT groups.
- Similar duration of PN, time to full enteral feeding, and growth parameters at discharge were observed.
- While the overall incidence of parenteral nutrition-associated cholestasis (PNAC) was similar, infants receiving SMOF showed significantly lower peak direct bilirubin and ALT levels, indicating reduced PNAC severity.
Conclusions:
- SMOF emulsion did not decrease the overall complication rates in ELBW infants compared to MCT/LCT.
- SMOF emulsion may reduce the severity of parenteral nutrition-associated cholestasis (PNAC) in ELBW infants.
- Further research is warranted to fully elucidate the role of multi-oil fat emulsions in neonatal nutrition.
Objective:
To study the clinical effect of multi-oil fat emulsion for parenteral nutrition support in extremely low birth weight (ELBW) infants.
Methods:
A retrospective analysis was performed for 49 ELBW infants who were admitted from January 1, 2018 to July 30, 2020, with an age of ≤14 days on admission and a duration of parenteral nutrition of > 14 days. According to the type of lipid emulsion received, the ELBW infants were divided into two groups: soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOF) (n=26) and medium-chain triglycerides/long-chain triglycerides (MCT/LCT) (n=23). The two groups were compared in terms of clinical features, complications, nutrition support therapy, and outcome.
Results:
The 49 ELBW infants had a mean birth weight of (892±83) g and a mean gestational age of (28.2±2.3) weeks. There was no significant difference between the two groups in the incidence rates of hemodynamically significant patent ductus arteriosus, intraventricular hemorrhage, neonatal necrotizing enterocolitis, retinopathy of prematurity, bronchopulmonary dysplasia (BPD), grade Ⅲ BPD, sepsis, and pneumonia (P > 0.05). There was also no significant difference in the duration of parenteral nutrition, the age of total enteral nutrition, and head circumference/body length/body weight at discharge between the two groups (P > 0.05). Of all the infants, 22 (45%) had parenteral nutrition-associated cholestasis (PNAC), with 13 (50%) in the SMOF group and 9 (39%) in the MCT/LCT group but there was no significant difference in the incidence of PNAC between the two groups (P > 0.05); however, the infants with PNAC in the SMOF group had significantly lower peak values of direct bilirubin and alanine aminotransferase than those in the MCT/LCT group (P < 0.05).
Conclusions:
The application of multi-oil fat emulsion in ELBW infants does not reduce the incidence rate of complications, but compared with MCT/LCT emulsion, SMOF can reduce the severity of PNAC in ELBW infants.
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