Document Detail


Resolution of Parenteral Nutrition Associated Jaundice on Changing From a Soya-Oil Emulsion to a Complex Mixed-Lipid Emulsion.
MedLine Citation:
PMID:  22157927     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: 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. OBJECTIVES:: To examine to effect on PN associated jaundice of changing from a soya oil derived lipid (Intralipid, Fresenius Kabi) to a mixed lipid emulsion derived from soybean, coconut, olive and fish oil (SMOFlipid, Fresenius Kabi) without reducing the total amount of lipid given. PATIENTS & METHODS:: Retrospective cohort comparison examining serum bilirubin over 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 versus 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 versus Intralipid: 50%, range 37.6-76; P = 0.15). The median bilirubin at the outset was 143 micromol/l (range 71-275) in the SMOFlipid group and 91 micromol/l (range 78-176) in the Intralipid group. After 6 months 5/8 in the SMOFlipid and 2/9 in the Intralipid group had total resolution of jaundice. The median bilirubin fell by 99 micromol/l in the SMOFlipid group but increased by 79 micromol/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. Randomized trials are needed to study the efficacy of SMOFlipid in preventing PN liver disease.
Authors:
Rafeeq Muhammed; Ronald Bremner; Sue Protheroe; Tracey Johnson; Chris Holden; M Stephen Murphy
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-7
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  -     ISSN:  1536-4801     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Department of Paediatric Gastroenterology †Department of Dietetics ‡Nutritional Care Team, Birmingham Children's Hospital NHS Foundation Trust, England §School of Clinical & Experimental Medicine, College of Medical & Dental Sciences, University of Birmingham, England.
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