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Published on: September 20, 2019
Clinical effects of multi-oil versus pure soybean oil-based lipid emulsions for preterm infants: An observational
Xing Li1, Rui Zhao1, Hai-Feng Lv2
1Department of Pharmacy, Qiantang Campus, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang Uni-versity, Hangzhou, China.
Insights
Multi-oil-based lipid emulsions (SMOFlipid) showed improved clinical efficacy in preterm infants compared to soybean oil-based emulsions (Intralipid). SMOFlipid was linked to reduced retinopathy of prematurity and shorter hospital stays, suggesting benefits for neonatal health outcomes.
Area of Science:
- Neonatalogy
- Clinical Nutrition
- Pediatric Gastroenterology
Background:
- Conventional soybean oil-based intravenous lipid emulsions (SO-ILEs) contain high polyunsaturated fatty acids and phytosterols, potentially posing risks to preterm infants.
- Multi-oil-based intravenous lipid emulsions (MO-ILEs), such as SMOFlipid, are increasingly used in neonatal intensive care units (NICUs).
- Evidence for MO-ILE benefits over SO-ILEs in very preterm infants remains limited.
Purpose of the Study:
- To compare the clinical efficacy of SMOFlipid versus Intralipid in preterm infants.
- To investigate differences in neonatal health outcomes, including morbidity, between the two lipid emulsion types.
- To evaluate the impact on retinopathy of prematurity (ROP) and hospital length of stay.
Main Methods:
- Retrospective review of preterm infants (gestational age <32 weeks) requiring parenteral nutrition for ≥14 days between 2016 and 2021.
- Analysis of infants receiving either SMOFlipid or Intralipid as their primary lipid emulsion.
- Comparison of morbidity rates, ROP incidence, and hospital length of stay between the two groups.
Main Results:
- A total of 262 infants were analyzed: 126 received SMOFlipid and 136 received Intralipid.
- The SMOFlipid group exhibited lower rates of retinopathy of prematurity (ROP) (23.8% vs. 37.5%, p=0.017).
- Infants receiving SMOFlipid had a significantly shorter hospital stay (median 64.8 days vs. 72.5 days, p<0.001).
Conclusions:
- SMOFlipid use was associated with higher clinical efficacy in preterm infants compared to SO-ILEs.
- The findings suggest potential benefits of MO-ILEs in reducing ROP and hospital length of stay.
- SMOFlipid may be a more advantageous lipid emulsion for optimizing outcomes in preterm neonates.
Background And Objectives:
Conventional soybean oil-based intravenous lipid emulsions (SO-ILEs) have high polyunsaturated fatty acid (PUFA) contents and phytosterols that may have adverse effects in preterm infants. Recently, the multi-oil-based intravenous lipid emulsion (MO-ILE), SMOFlipid, has been widely utilized in the neonatal intensive care unit (NICU), but significant benefits over SO-ILEs in low gestational age neonates have yet to be demonstrated. This study was performed to compare the effects of the SO-ILE, Intralipid, and the MO-ILE, SMOFlipid, on neonatal health outcomes in preterm infants.
Methods And Study Design:
We performed a retrospective review of preterm infants born at gestational week (GW) <32 receiving parenteral nutrition for longer durations (≥14 d) in the NICU between 2016 and 2021. The primary aim of this study was to investigate differences in morbidity between preterm infants receiving SMOFlipid and Intralipid.
Results:
A total of 262 preterm infants were included in the analysis, with 126 receiving SMOFlipid and 136 receiving Intralipid. The SMOFlipid group had lower rates of ROP (23.8% vs 37.5%, respectively; p=0.017), although the rate of ROP was not different in multivariate regression analysis. The length of hospi-tal stay was significantly shorter in the SMOFlipid than SO-ILE group (median [IQR]=64.8 [37] vs 72.5 [49] days; p<0.001).
Conclusions:
The use of SMOFlipid as the lipid emulsion was associated with higher clinical efficacy than SO-ILE in preterm infants.
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