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Published on: September 20, 2019
Comparison of Alternative Lipid Emulsions on Morbidities in Very-Low-Birth-Weight Preterms
Adil Umut Zübarioğlu1, Mesut Dursun2
1Medical Faculty, Neonatal Intensive Care Unit, Istanbul Yeni Yuzyıl University, Gaziosmanpasa, 34245, Istanbul, Turkey. uzubari@hotmail.com.
Insights
SMOFlipid and Clinoleic are equally safe lipid emulsions for preterm infants requiring parenteral nutrition. Longer duration use showed no significant difference in major morbidities between the two in multivariate analysis.
Area of Science:
- Neonatalogy
- Clinical Nutrition
- Pediatric Critical Care
Background:
- Parenteral nutrition is essential for preterm infants at high risk for morbidities.
- Alternative lipid emulsions are increasingly used, necessitating safety and efficacy comparisons.
- Longer durations of use require evaluation for potential clinical outcomes.
Purpose of the Study:
- To compare clinical outcomes of SMOFlipid versus Clinoleic in preterm infants receiving parenteral nutrition for ≥ 14 days.
- To assess the safety and efficacy of alternative lipid emulsions in a high-risk neonatal population.
- To identify any significant differences in morbidities associated with different lipid emulsion types.
Main Methods:
- Retrospective study comparing preterm infants (≤ 30 weeks gestation) receiving SMOFlipid or Clinoleic.
- Data collected on demographic features, clinical applications, and morbidities over two 1-year epochs.
- Bivariate and multivariate logistic regression analyses were performed to compare outcomes.
Main Results:
- Bivariate analysis showed higher rates of moderate bronchopulmonary dysplasia (BPD) and a composite outcome in the Clinoleic group.
- The composite outcome included BPD, retinopathy of prematurity requiring treatment, cholestasis, and late-onset sepsis/mortality.
- Multivariate logistic regression revealed no significant effect of lipid emulsion type on these morbidities.
Conclusions:
- Both SMOFlipid and Clinoleic demonstrated comparable safety profiles in preterm infants requiring parenteral nutrition.
- The choice of lipid emulsion did not significantly impact major morbidities or mortality in this cohort.
- Further research may explore specific subgroups or long-term outcomes.
Objective:
To compare clinical outcomes of using different alternative lipid emulsions for longer durations in babies who are at high risk for preterm morbidities.
Methods:
Preterm infants born ≤ 30 wk receiving SMOFlipid versus Clinoleic with longer durations (≥ 14 d) were included in this retrospective study. The authors compared demographic features, clinical applications, and morbidities between epochs: epoch 1 (Clinoleic, July 2017-June 2018) versus epoch 2 (SMOFlipid, July 2018-June 2019).
Results:
A total of 91 infants were included in the study. In bivariate analysis; moderate bronchopulmonary dysplasia (BPD) (p = 0.000) and composite outcome [BPD, retinopathy of prematurity (ROP) needed treatment, cholestasis and late-onset sepsis and/or mortality] rates were significantly higher (p = 0.043) in Clinoleic group. In multivariate logistic regression analysis, it was found that the type of lipid emulsion used had no significant effect on these morbidities.
Conclusions:
Since both groups had comparable morbidity and mortality, both lipid emulsions are equally safe in preterm babies requiring parenteral nutrition.
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