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[Fat utilization in newborn infants with and without heparin administration. Comparative study with the 13C-triolein
Insights
Heparin does not increase fatty acid oxidation in premature infants, despite accelerating lipid elimination. This study found no significant difference in the utilization of intravenously administered lipids for energy production with or without heparin.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pediatric Nutrition
Background:
- Parenteral lipid administration is common in premature infants.
- Heparin can accelerate lipid clearance via lipoprotein lipase activation.
- The impact of heparin on fatty acid oxidation in neonates is not well-established.
Purpose of the Study:
- To investigate whether heparin enhances fatty acid oxidation in premature infants.
- To determine if increased lipolysis from heparin leads to greater energy utilization.
Main Methods:
- Five premature infants received intravenous triolein labeled with 13C.
- 13CO2 exhalation was measured via mass spectrometry over 6 hours.
- Oxidation was assessed with and without a single heparin injection (10 U/kg).
Main Results:
- Heparin administration did not significantly alter 13CO2 exhalation.
- Fatty acid oxidation rates were similar: 32.0% +/- 2.57% without heparin and 31.6% +/- 2.34% with heparin.
- No increased fatty acid oxidation was observed after a single heparin dose.
Conclusions:
- A single intravenous dose of heparin (10 U/kg) does not increase fatty acid oxidation in premature infants.
- Heparin's role in enhancing lipid utilization for energy in this population requires further investigation.
- Current evidence does not support heparin use for boosting energy production from parenteral lipids in neonates.
Abstract:
The elimination of parenterally administered lipids from the bloodstream of premature infants can be accelerated by activation of the lipoprotein-lipase using heparin. We have no evidence that the free fatty acids increasing under enhanced lipolytical activity are utilized for energy production. For this reason, the oxidation rates of intravenously administered lipids in premature infants are examined both with and without heparin. Triolein marked with 13C and processed in soybean oil is administered intravenously at a dosage of 10 mg/kg. 13CO2 results from fatty acid oxidation and is exhaled through the lungs, whereafter it is collected in separate breath samples over a period of 6 hours and determined by mass spectrometry. The examination was performed in 5 premature infants, first without heparin, then after heparin injection (10 U/kg). The extent of 13CO2 exhalation was not significantly influenced by heparin. Without heparin supply we measured a fatty acid oxidation of 32.0 +/- 2.57% which was the same (31.6 +/- 2.34%) after heparin injection. Single intravenous administration of 10 U heparin/kg does not cause increased fatty acid oxidation in premature infants.