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Cholestasis, Bronchopulmonary Dysplasia, and Lipid Profile in Preterm Infants Receiving MCT/ω-3-PUFA-Containing or Soybean-Based Lipid Emulsions.
MedLine Citation:
PMID:  22878361     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: This study aimed to compare the effect of 2 lipid emulsions (LEs), a medium-chain triglyceride (MCT)/ω-3-polyunsaturated fatty acid (PUFA)-containing LE and a soybean-based LE, on the incidence of neonatal cholestasis, bronchopulmonary dysplasia (BPD), and lipid profile of preterm infants. Patients and METHODS: In this prospective, observational study, 2 groups of preterm neonates, the very low birth weight (VLBW) (n = 129) and the low birth weight (LBW) groups (n = 153), which received parenteral LEs for at least 7 days, were included. Infants received either MCT/ω-3-PUFA-containing LE (SMOFlipid, subgroup I) or soybean-based LE (Intralipid, subgroup II) according to the attending neonatologist's preference and availability. Full biochemical assessment was performed on days of life 15, 30, and 45 and on discharge. RESULTS: Of the VLBW infants, 7.4% and 13.3% of infants in subgroups I and II, respectively, developed cholestasis (P = .39; odds ratio [OR], 0.52; 95% confidence interval [CI], 0.15-1.76). The duration of LE administration was independently associated with cholestasis (P < .001; OR, 0.925; 95% CI, 0.888-0.963). The maximum amounts of lipids administered ranged between 1.6 and 3.6 g/kg/d in both VLBW subgroups. The VLBW subgroup I had lower incidence of BPD, lower alkaline phosphatase and phosphate, higher high-density lipoprotein (HDL), and lower cholesterol-to-HDL ratio on discharge than the VLBW subgroup II. The type of LE was independently associated with BPD and alkaline phosphatase. In the LBW group, the type of LE was not associated with clinical and biochemical parameters. CONCLUSION: In VLBW infants, the MCT/ω-3-PUFA-containing LE administration is associated with decreased BPD and more favorable lipoprotein profile. Although a trend toward a lower incidence of cholestasis was observed, a preventive effect of MCT/ω-3-PUFA-containing LE on parenteral nutrition-associated cholestasis is not supported. (Nutr Clin Pract. XXXX;xx:xx-xx).
Authors:
Maria Skouroliakou; Dimitris Konstantinou; Charalampos Agakidis; Natalia Delikou; Katerina Koutri; Marina Antoniadi; Thomais Karagiozoglou-Lampoudi
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-9
Journal Detail:
Title:  Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition     Volume:  -     ISSN:  1941-2452     ISO Abbreviation:  Nutr Clin Pract     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8606733     Medline TA:  Nutr Clin Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Harokopio University, Athens, Greece.
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