Morbidity Outcomes of Very Low Birth Weight Neonates Receiving Parenteral Nutrition with Fish Oil Enriched Lipid Emulsion or Lipid Emulsion with Soybean Oil: An Observational Study

Abstract

Intralipid (Fresenius Kabi) was the most commonly used lipid emulsion in parenteral nutrition (PN), with a 100% soybean oil composition, a low vitamin E content, and a ω-6: ω-3 ratio of 7:1. A recent alternative formulation is SMOFlipid (Fresenius Kabi), with a ω-6: ω-3 ratio of 5:2 and higher vitamin E content. A retrospective observational study was conducted to determine neonatal morbidity in very low birth weight (VLBW) premature infants during two periods: P1, when PN was based exclusively on Intralipid, and P2, when only SMOFlipid was supplied. In total, 170 VLBW neonates were analyzed, of whom 103 received PN for more than 6 days, 56 during P1, and 47 during P2. In both periods, the antenatal and neonatal characteristics of the cohort were comparable. In this analysis, the prevalence of associated comorbidities was determined. During P2, there were fewer cases of moderate to severe bronchopulmonary dysplasia (BPD) and of cholestasis, but more cases of late sepsis, mainly Staphylococcus epidermidis. No changes in the prevalence of other neonatal comorbidities were observed. We believe that the SMOFlipid used in PN could discreetly improve the prevalence of cholestasis or BPD.

Keywords

parenteral nutrition - neonatal morbidity - long-chain polyunsaturated fatty acids - bronchopulmonar dysplasia - late onset sepsis - necrotizing enterocolitis - intraventricular hemorrhage - persistent ductus arteriosus

Authors' Contributions

All authors have read and approved the final manuscript. J.U. designed the research study and drafted the manuscript. S.J.M., M.M.O., P.N.G., and E.N.L. coordinated and prepared the database and analyzed the data.

Ethical Approval

The protocol was approved by the ethics committee of the hospital and all current regulations regarding data confidentiality were complied with.

Publikationsverlauf

Eingereicht: 12. August 2019

Angenommen: 17. Dezember 2019

Artikel online veröffentlicht:
27. Januar 2020

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