Elimination of Soybean Lipid Emulsion in Parenteral Nutrition and Supplementation With Enteral Fish Oil Improve Cholestasis in Infants With Short Bowel Syndrome

Abstract

Temporary elimination of SLE and supplementation with enteral fish oil improved cholestasis in PN-dependent infants. Further trials are needed to evaluate this management strategy.

Lipids for parenteral nutrition in neonates

“…Participants who received fish oil-based lipid emulsion experienced reversal of cholestasis 4.8 times faster than those who received soybean oil-based lipid emulsion. Similar results were reported by two other recent studies [44,45]. The study by Diamond et al used a different lipid regimen, in which instead of using Omegaven (Fresenus Kabi) alone they have used 1 : 1 combination of Omegaven and Intralipid (B. Braun) in order to provide additional energy and n-6 LC-PUFAs.…”

Parenteral nutrition–associated cholestasis: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review

“…In a retrospective review of a single-institution experience with the treatment of PNALD, Rollins and colleagues [45] reported that the temporary elimination of soybean-based lipid emulsion and supplementation of enteral fish oil (25 m g kg −1 d −1 ) improved PNAC. Four patients who were treated in this manner ultimately had resolution of PNAC.…”

Short bowel syndrome in infants: the critical role of luminal nutrients in a management program

“…Multiple causative factors, such as catheterrelated sepsis, bacterial overgrowth, abnormal bile acids, excess amino acids, and soy-based intravenous lipid emulsions, have been implicated (Rangel et al 2012). Studies are ongoing on the role of omega-3 lipids (Omegaven) in treating and preventing PNALD and are very encouraging Rollins et al 2010;Premkumar et al 2013). Weaning patients off PN as early as possible by optimizing EN remains the only way to prevent PNALD (Wiles and Woodward 2009).…”