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Fat elimination in parenterally fed low birth weight infants during the first two weeks of life
Insights
Preterm infants can safely metabolize Intralipid (a fat emulsion) when given at maximal doses and infusion rates. This supports its use in parenteral nutrition for low birth weight infants.
Area of Science:
- Neonatalogy
- Clinical Nutrition
- Biochemistry
Background:
- Low birth weight infants often require parenteral nutrition.
- Assessing the safe and effective delivery of Intralipid in preterm neonates is crucial.
Purpose of the Study:
- To evaluate the elimination and metabolic tolerance of Intralipid in low birth weight preterm infants receiving maximal doses.
Main Methods:
- Infusion of Intralipid (2 g/kg/24 hr) in 18 preterm infants (27-34 wk gestation).
- Monitoring serum triglyceride levels and fatty acid profiles via enzymatic assays and gas chromatography.
- Comparison with enterally fed preterm infants.
Main Results:
- Serum triglyceride levels remained within normal limits, with no hypertriglyceridemia observed.
- Linoleic acid levels increased significantly, reaching normal ranges for enterally fed infants.
- Infants demonstrated effective elimination of Intralipid.
Conclusions:
- Preterm infants can eliminate Intralipid at maximal dosage and infusion rates.
- Parenteral nutrition with Intralipid is well-tolerated in this population.
- This study supports the use of Intralipid in neonatal intensive care settings.
Abstract:
Eighteen low birth weight infants (27-34 wk gestation) were given supplementary parenteral nutrition via peripheral veins of a maximal dose of 8.5 g glucose, 2.5 g amino acids (Aminovenös päd 10%) and 2 g soybean oil egg lecithin emulsion (Intralipid 10%) kg body weight/24 hr. The fat emulsion was infused continuously at a rate of 0.084 g/kg body weight/hr. The elimination of Intralipid from the blood stream was controlled by enzymatic determination of serum triglyceride concentrations, and the fatty acid pattern of the serum lipids was determined by gas chromatography. The serum triglyceride concentrations were 0.60 +/- 0.16 mmol/liter on the 1st day, increased to 0.96 +/- 0.29 mmol/liter up to the 5th day, and approached a level around 0.90 mmol/liter in the further course. No hypertriglyceridemia was noted. The fatty acid pattern of the serum lipids showed a linoleic acid fraction of 8.1 +/- 4.0% in the beginning, which was followed by a continuous increase up to 27.8 +/- 4.8% on the 7th day. No significant changes were noticed thereafter. The levels were within the normal limits as found in 2-wk-old enterally fed preterm infants of comparative maturity (25.6 +/- 3.4%). We conclude that the preterm infants can eliminate Intralipid from the blood stream if maximal dosage and infusion rate, as described above, are applied.