TY - JOUR
T1 - Resolution of Parenteral Nutrition-associated Jaundice on Changing From a Soybean Oil Emulsion to a Complex Mixed-Lipid Emulsion.
AU - Muhammed, R
AU - Bremner, R
AU - Protheroe, S
AU - Johnson, T
AU - Holden, C
AU - Murphy, Michael
PY - 2012/6/1
Y1 - 2012/6/1
N2 - BACKGROUND AND OBJECTIVE
: Resolution of parenteral nutrition (PN)-associated jaundice has been reported in children given a reduced dose of intravenous fat using a fish oil-derived lipid emulsion. The aim of the present study was to examine the effect on PN-associated jaundice of changing from a soybean oil-derived lipid to a mixed lipid emulsion derived from soybean, coconut, olive, and fish oils without reducing the total amount of lipid given.
METHODS
: Retrospective cohort comparison examining serum bilirubin during 6 months in children with PN-associated jaundice who changed to SMOFlipid (n = 8) or remained on Intralipid (n = 9).
RESULTS
: At entry, both groups received most of their energy as PN (SMOFlipid 81.5%, range 65.5-100 vs Intralipid 92.2%, range 60.3-100; P = 0.37). After 6 months, both tolerated increased enteral feeding but still received large proportions of their energy as PN (SMOFlipid 68.4%, range 36.6-100 vs Intralipid 50%, range 37.6-76; P = 0.15). The median bilirubin at the outset was 143 μmol/L (range 71-275) in the SMOFlipid group and 91 μmol/L (range 78-176) in the Intralipid group. After 6 months, 5 of 8 children in the SMOFlipid and 2 of 9 children in the Intralipid group had total resolution of jaundice. The median bilirubin fell by 99 μmol/L in the SMOFlipid group but increased by 79 μmol/L in the Intralipid group (P = 0.02).
CONCLUSIONS
: SMOFlipid may have important protective properties for the liver and may constitute a significant advance in PN formulation. Randomised trials are needed to study the efficacy of SMOFlipid in preventing PN liver disease.
AB - BACKGROUND AND OBJECTIVE
: Resolution of parenteral nutrition (PN)-associated jaundice has been reported in children given a reduced dose of intravenous fat using a fish oil-derived lipid emulsion. The aim of the present study was to examine the effect on PN-associated jaundice of changing from a soybean oil-derived lipid to a mixed lipid emulsion derived from soybean, coconut, olive, and fish oils without reducing the total amount of lipid given.
METHODS
: Retrospective cohort comparison examining serum bilirubin during 6 months in children with PN-associated jaundice who changed to SMOFlipid (n = 8) or remained on Intralipid (n = 9).
RESULTS
: At entry, both groups received most of their energy as PN (SMOFlipid 81.5%, range 65.5-100 vs Intralipid 92.2%, range 60.3-100; P = 0.37). After 6 months, both tolerated increased enteral feeding but still received large proportions of their energy as PN (SMOFlipid 68.4%, range 36.6-100 vs Intralipid 50%, range 37.6-76; P = 0.15). The median bilirubin at the outset was 143 μmol/L (range 71-275) in the SMOFlipid group and 91 μmol/L (range 78-176) in the Intralipid group. After 6 months, 5 of 8 children in the SMOFlipid and 2 of 9 children in the Intralipid group had total resolution of jaundice. The median bilirubin fell by 99 μmol/L in the SMOFlipid group but increased by 79 μmol/L in the Intralipid group (P = 0.02).
CONCLUSIONS
: SMOFlipid may have important protective properties for the liver and may constitute a significant advance in PN formulation. Randomised trials are needed to study the efficacy of SMOFlipid in preventing PN liver disease.
U2 - 10.1097/MPG.0b013e3182447daf
DO - 10.1097/MPG.0b013e3182447daf
M3 - Article
C2 - 22157927
SN - 1536-4801
VL - 54
SP - 797
EP - 802
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
IS - 6
ER -