Influence of Soybean Oil or Non-Soybean Oil Based Lipid Emulsions on Parenteral Nutrition Associated Liver Disease in Late Preterm and Term Infants
DOI:
https://doi.org/10.6000/1929-4247.2014.03.04.4Keywords:
Parenteral Nutrition-Associated Liver Disease, lipid emulsion, fish-oil, soy, soybean, cholestasis, neonates, total parenteral nutrition, term infants.Abstract
Background: Total parenteral nutrition (TPN) is a life-saving therapy given to neonates with intestinal failure. However, infants on long-term TPN may experience Parenteral Nutrition-Associated Liver Disease (PNALD). New formulations for lipid emulsions are purportedly better than the traditional soy-based lipid emulsions (SLE). Our primary objective was to determine the prevalence of PNALD in infants who received non-soybean-based lipid emulsions (NSLE) or SLE.
Methods: In this retrospective study, medical records of all infants admitted to a tertiary neonatal intensive care unitfrom 2004 to 2013 were reviewed. Late preterm (34 -36 weeks of gestation) and term infants who were on TPN for more than two weeks were included. Their demographic data and clinical variables were collected.
Results: 208 infants received SLE for more than two weeks. The prevalence rate of PNALD in those who received SLE was 21% while that of those who received the NSLE was 17%. No significant difference was found between the ‘Soy’ or ‘NonSoy’ subgroups (p = 0.315). Seventy infants received TPN for more than four weeks. The prevalence rate of PNALD in infants who received SLE and NSLE was 35% and 25% respectively. No significant statistical difference was found between the ‘Soy’ or ‘NonSoy’ subgroups (p = 0.132).
Conclusions: The type of lipid emulsion does not significantly influence the rate of PNALD in late preterm and term infants on long-term TPN.
References
Lee V. Liver Dysfunction Associated with Parenteral Nutrition: What Are the Options? Practical Gastroenterology 2006; [cited 2013 May 14]. Available from:http://www.medicine.virginia.edu/clinical/departments/medicine/divisions/digestive-health/nutrition-support-team/nutrition-articles/LeeArticle.pdf
Rangel SJ, Calkins CM, Cowles RA, et al. Parenteral nutrition-associated cholestasis: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review. J Pediatr Surg 2012; 47(1): 225-40. http://dx.doi.org/10.1016/j.jpedsurg.2011.10.007
Colomb V, Jobert-Giraud A, Lacaille F, Goulet O, Fournet JC, Ricour C. Role of lipid emulsions in cholestasis associated with long-term parenteral nutrition in children. JPEN J Parenter Enteral Nutr 2000; 24: 345-50. http://dx.doi.org/10.1177/0148607100024006345
Deshpande G, Simmer K. Lipids for parenteral nutrition in neonates. Curr Opin Clin Nutr Metab Care 2011; 14: 145-50. http://dx.doi.org/10.1097/MCO.0b013e3283434562
Mateu-de Antonio J, Grau S, Luque S, Marin-Casino M, Albert I, Ribes E. Comparative effects of olive oil-based and soyabean oil-based emulsions on infection rate and leucocyte count in critically ill patients receiving parenteral nutrition. Br J Nutr 2008; 99: 846-54. http://dx.doi.org/10.1017/S0007114507837433
Kalish BT, Le HD, Gura KM, Bistrian BR, Puder M. A metabolomic analysis of two intravenous lipid emulsions in a murine model. PLoS One 2013; 8: e59653. http://dx.doi.org/10.1371/journal.pone.0059653
Sanchez SE, Braun LP, Mercer LD, Sherrill M, Stevens J, Javid PJ. The effect of lipid restriction on the prevention of parenteral nutrition-associated cholestasis in surgical infants. J Pediatr Surg 2013; 48: 573-8. http://dx.doi.org/10.1016/j.jpedsurg.2012.08.016
Chang MI, Puder M, Gura KM. The use of fish oil lipid emulsion in the treatment of intestinal failure associated liver disease (IFALD). Nutrients 2012; 4: 1828-50. http://dx.doi.org/10.3390/nu4121828
Koseesirikul P, Chotinaruemol S, Ukarapol N. Incidence and risk factors of parenteral nutrition-associated liver disease in newborn infants. Pediatr Int 2012; 54: 434-6. http://dx.doi.org/10.1111/j.1442-200X.2012.03627.x
Tomsits E, Pataki M, Tolgyesi A, Fekete G, Rischak K, Szollar L. Safety and efficacy of a lipid emulsion containing a mixture of soybean oil, medium-chain triglycerides, olive oil, and fish oil: a randomised, double-blind clinical trial- in premature infants requiring parenteral nutrition. J Pediatr Gastroenterol Nutr 2010; 51: 514-21. http://dx.doi.org/10.1097/MPG.0b013e3181de210c
Clayton PT, Whitfield P, Iyer K. The role of phytosterols in the pathogenesis of liver complications of pediatric parenteral nutrition. Nutrition 1998; 14: 158-64. http://dx.doi.org/10.1016/S0899-9007(97)00233-5
Lam HS, Tam YH, Poon TC, et al. A double-blind randomised controlled trial of fish oil-based vs. soy-based lipid preparations in the treatment of infants with parenteral nutrition-associated cholestasis. Neonatology 2014; 105: 290-6. http://dx.doi.org/10.1159/000358267
Rollins MD, Scaife ER, Jackson WD, Meyers RL, Mulroy CW, Book LS. Elimination of soybean lipid emulsion in parenteral nutrition and supplementation with enteral fish oil improve cholestasis in infants with short bowel syndrome. Nutr Clin Pract 2010; 25: 199-204. http://dx.doi.org/10.1177/0884533610361477
Robinson DT, Ehrenkranz RA. Parenteral nutrition-associated cholestasis in small for gestational age infants. J Pediatr 2008; 152: 59-62. http://dx.doi.org/10.1016/j.jpeds.2007.06.002
Nandivada P, Carlson SJ, Cowan E, Chang MI, Gura KM, Puder M. Role of parenteral lipid emulsions in the preterm infant. Early Hum Dev 2013; 89(Suppl 2): S45-9. http://dx.doi.org/10.1016/j.earlhumdev.2013.08.005
Kalish BT, Le HD, Fitzgerald JM, et al. Intravenous fish oil lipid emulsion promotes a shift toward anti-inflammatory proresolving lipid mediators. Amjphysiol 2013; 305: G818-28. http://dx.doi.org/10.1152/ajpgi.00106.2013
Thibault M, McMahon J, Faubert G, et al. Parenteral nutrition-associated liver disease: a retrospective study of ursodeoxycholic Acid use in neonates. J Pediatr Pharmacolther 2014; 19: 42-8. http://dx.doi.org/10.5863/1551-6776-19.1.42
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