| Effect of early initiation of intravenous lipid administration on the incidence and severity of chronic lung disease in premature infants. | |
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MedLine Citation:
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PMID: 8229533 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate whether intravenous administration of lipid nutrition (Intralipid) within 12 hours of birth to ventilator-dependent premature infants would decrease the incidence or severity, or both, of chronic lung disease. METHOD: We randomly assigned 133 infants to Intralipid or control groups, using two weight strata: 42 Intralipid versus 37 control subjects in the 600 to 800 gm stratum, and 28 Intralipid versus 26 control subjects in the 801 to 1000 gm stratum. The Intralipid group received 20% Intralipid at < 12 hours after birth, starting at a dose of 0.5 gm/kg and increasing to a maximum of 1.5 gm/kg, maintained through day 7. Control infants received no lipid until after day 7. Neither group received enteral feedings until after day 7. RESULTS: No significant differences in mortality rates were present in the total population (23/70 = 32.9% vs 16/63 = 25.4%; p = 0.35, Intralipid vs control); however, the mortality rate increased significantly in 600 to 800 gm infants receiving Intralipid versus the control infants (20/41 = 47.5% vs 9/37 = 24.3%; p = 0.032). No significant differences were found in the number of infants in whom chronic lung disease developed (requiring oxygen for > or = 28 days), proportion requiring oxygen for > or = 60 days, number of survivors without chronic lung disease, or total oxygen and ventilation requirements. However, 600 to 800 gm infants receiving Intralipid had significantly more pulmonary hemorrhage, and greater numbers of infants receiving Intralipid in both weight categories required supplemental oxygen at day 7. The incidence of other complications of prematurity, time required to regain birth weight, and duration of hospital stay did not differ between groups. CONCLUSION: Intralipid administration initiated at < 12 hours after birth failed to protect very low birth weight premature infants from chronic lung disease. Some of the results raise questions about possible deleterious effects of Intralipid when administered early in the first week of life. |
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Authors:
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I R Sosenko; M Rodriguez-Pierce; E Bancalari |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of pediatrics Volume: 123 ISSN: 0022-3476 ISO Abbreviation: J. Pediatr. Publication Date: 1993 Dec |
Date Detail:
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Created Date: 1993-12-22 Completed Date: 1993-12-22 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 975-82 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatrics (R-131), University of Miami School of Medicine, FL 33101. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Chronic Disease Fat Emulsions, Intravenous / administration & dosage, metabolism, therapeutic use* Humans Infant, Low Birth Weight Infant, Newborn Infant, Premature Infant, Premature, Diseases / mortality, prevention & control* Lung Diseases / mortality, prevention & control* Survival Rate |
| Chemical | |
Reg. No./Substance:
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0/Fat Emulsions, Intravenous |
| Comments/Corrections | |
Comment In:
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J Pediatr. 1994 Aug;125(2):329-30
[PMID:
8093165
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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