Short-term Use of Parenteral Nutrition with a Lipid Emulsion Containing a Mixture of Soybean Oil, Olive Oil, Medium-chain Triglycerides, and Fish Oil: a Randomized Double-blind Study in Preterm Infants
Overview
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Background: For premature neonates needing parenteral nutrition (PN), a balanced lipid supply is crucial. The authors hypothesized that a lipid emulsion containing medium-chain triglycerides (MCTs) and soybean, olive, and fish oils would be as safe and well tolerated as a soybean emulsion while beneficially influencing the fatty acid profile.
Methods: Double-blind, controlled study in 53 neonates (<34 weeks' gestation) randomized to receive at least 7 days of PN containing either an emulsion of MCTs and soybean, olive, and fish oils or a soybean oil emulsion. Target lipid dosage was 1.0 g fat/kg body weight [BW]/d on days 1-3, 2 g/kg BW/d on day 4, 3 g/kg BW/d on day 5, and 3.5 g/kg BW/d on days 6-14.
Results: Test emulsion vs control, mean ± SD: baseline triglyceride concentrations were 0.52 ± 0.16 vs 0.54 ± 0.19 mmol/L and increased similarly in both groups to 0.69 ± 0.38 vs 0.67 ± 0.36 on day 8 of treatment (P = .781 for change). A significantly higher decrease in total and direct bilirubin vs baseline was seen in the test group compared with the control group P < .05 between groups). In plasma and red blood cell phospholipids, eicosapentaenoic acid and docosahexaenoic acid were higher, and the n-6/n-3 fatty acid ratio was lower in the test group (P < .05 vs control).
Conclusions: The lipid emulsion, based on a mixture of MCTs and soybean, olive, and fish oils, was safe and well tolerated by preterm infants while beneficially modulating the fatty acid profile.
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Goulet O Nutrients. 2024; 16(3).
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Gupta N, Ali C, Talathi S J Pediatr Pharmacol Ther. 2023; 28(4):329-334.
PMID: 37795287 PMC: 10547041. DOI: 10.5863/1551-6776-28.4.329.
Outcomes in preterm infants who received a lipid emulsion with fish oil: An observational study.
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SMOFlipid Impact on Growth and Neonatal Morbidities in Very Preterm Infants.
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