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Tytuł:
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A Comparison of Smoflipid® and Intralipid® in the Early Management of Infants with Intestinal Failure.
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Autorzy:
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Casson C; Division of Pediatric Surgery, University of Texas Southwestern/Children's Health, Dallas, TX, USA.
Nguyen V; Division of Gastroenterology, University of Texas Southwestern/Children's Health, Dallas, TX, USA.
Nayak P; Division of Neonatology, University of Texas Southwestern/Children's Health, Dallas, TX, USA.
Channabasappa N; Division of Gastroenterology, University of Texas Southwestern/Children's Health, Dallas, TX, USA.
Berris K; Division of Neonatology, University of British Columbia/BC Women's Hospital and Health Center, Vancouver, BC, Canada.
Panczuk J; Division of Neonatology, University of British Columbia/BC Women's Hospital and Health Center, Vancouver, BC, Canada.
Bhiladvala C; Division of Pediatric Surgery, University of British Columbia/BC Children's Hospital, Vancouver, BC, Canada.
Dasgupta T; Division of Pediatric Surgery, University of British Columbia/BC Children's Hospital, Vancouver, BC, Canada.
Piper HG; Division of Pediatric Surgery, University of British Columbia/BC Children's Hospital, Vancouver, BC, Canada. Electronic address: .
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Źródło:
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Journal of pediatric surgery [J Pediatr Surg] 2020 Jan; Vol. 55 (1), pp. 153-157. Date of Electronic Publication: 2019 Oct 25.
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Typ publikacji:
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Comparative Study; Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Philadelphia, PA : Saunders
Original Publication: New York.
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MeSH Terms:
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Parenteral Nutrition, Total*
Cholestasis/*prevention & control
Fat Emulsions, Intravenous/*therapeutic use
Intestinal Diseases/*therapy
Lipids/*therapeutic use
Phospholipids/*therapeutic use
Soybean Oil/*therapeutic use
Bilirubin/blood ; Cholestasis/blood ; Cholestasis/etiology ; Emulsions/therapeutic use ; Enteral Nutrition/adverse effects ; Female ; Fish Oils ; Humans ; Hyperbilirubinemia/blood ; Hyperbilirubinemia/etiology ; Infant ; Infant, Newborn ; Intestinal Diseases/complications ; Male ; Nutritional Support ; Olive Oil ; Retrospective Studies ; Triglycerides
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Contributed Indexing:
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Keywords: Cholestasis; Intestinal failure-associated liver disease; Lipid emulsion
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Substance Nomenclature:
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0 (Emulsions)
0 (Fat Emulsions, Intravenous)
0 (Fish Oils)
0 (Lipids)
0 (Olive Oil)
0 (Phospholipids)
0 (Triglycerides)
0 (soybean oil, phospholipid emulsion)
8001-22-7 (Soybean Oil)
C9H2L21V7U (SMOFlipid)
RFM9X3LJ49 (Bilirubin)
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Entry Date(s):
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Date Created: 20191102 Date Completed: 20200902 Latest Revision: 20201209
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Update Code:
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20240104
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DOI:
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10.1016/j.jpedsurg.2019.09.073
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PMID:
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31672409
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Purpose: Cholestasis is problematic for infants with intestinal failure (IF). The soy-based lipid Intralipid® (IL) has been implicated. An alternative, Smoflipid® (SMOF), is increasingly used. However, its role in cholestasis prevention is unclear. This study compares the incidence and degree of cholestasis between infants with IF receiving SMOF or IL.
Methods: Infants with IF receiving SMOF or IL during the first 8 weeks of parenteral nutrition (PN) support between 2014 and 2017 were reviewed. Clinical characteristics, cholestasis incidence (conjugated bilirubin (Cbili) >2 mg/dL for >2 weeks), and nutritional parameters were compared using Welch's t-test.
Results: 91% (21/23) of IL and 76% (16/21) of SMOF babies became cholestatic (p = 0.18). There was no significant difference in median peak Cbili, but SMOF babies normalized more quickly (p = 0.04). Median z-scores for weight were similar throughout the study. SMOF patients getting full PN had a lower incidence of cholestasis compared to IL patients (78% vs. 92%, p = 0.057), but those with cholestasis had similar peak Cbili, time to resolution, and growth.
Conclusion: Early use of Smoflipid® did not reduce the incidence of cholestasis compared to Intralipid® in infants with IF, but hyperbilirubinemia did resolve more quickly. SMOF may be most beneficial for infants tolerating no enteral nutrition.
Level of Evidence: Level III Retrospective Comparative Treatment Study.
Type of Study: Retrospective Review.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
