Improved Outcome in Neonatal Short Bowel Syndrome Using Parenteral Fish Oil in Combination With ω‐6/9 Lipid Emulsions

Angsten, Gertrud; Finkel, Yigael; Lucas, Steven; Kassa, Ann-Marie; Paulsson, Mattias; Lilja, Heléne Engstrand

doi:10.1177/0148607111430507

Cited by 56 publications

(47 citation statements)

References 50 publications

(79 reference statements)

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“…The 2:1 ratio of soybean oil to fish oil found in SMOF is apparently not sufficient to entirely prevent IFALD. Angsten et al 26 reported the outcome of 20 neonates, all of whom were started on PN with soybean‐based LE that was switched to a combination of fish oil (Omegaven) and ω‐6/9 LE (ClinOleic, Baxter, Maurepas, France) in a 1:1 ratio for IFALD. They showed that parenteral fish oil–based LE in combination with ω‐6/9 LE for premature infants with short bowel can reverse cholestasis and ultimately lead to reduced mortality.…”

Section: Discussionmentioning

confidence: 99%

Reversal of Intestinal Failure–Associated Liver Disease by Switching From a Combination Lipid Emulsion Containing Fish Oil to Fish Oil Monotherapy

Lee

Park

Yoon

et al. 2015

J Parenter Enteral Nutr

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Intestinal failure-associated liver disease (IFALD) is a serious complication of parenteral nutrition (PN). Studies have shown that the amount and content of intravenous lipid emulsions (LEs) used is closely related to the development of IFALD. We report 2 cases of IFALD reversed by switching from a combination lipid emulsion containing fish oil to fish oil monotherapy (Omegaven; Fresenius Kabi Austria Gmbh, Graz, Austria). Patients initially received PN containing SMOFlipid 20% (SMOF; Fresenius Kabi Austria Gmbh, Graz, Austria), 2.0-3.0 g/kg/d, over 24 hours. When IFALD developed, LE was switched from SMOF to Omegaven starting at 1.0 g/kg/d over 12 hours. Case 1 was an 11-month-old girl with a diagnosis of extensive Hirschsprung disease up to the proximal jejunum. She developed direct bilirubinemia at 3 months, and the patient's LE was switched to Omegaven. A decrease in direct bilirubin was observed after 60 days on Omegaven, and IFALD was completely resolved after 90 days. Case 2 was a 1-month-old boy with a history of gastroschisis diagnosed with megacystis microcolon intestinal hypoperistalsis syndrome. He could not tolerate any oral feeds and was kept on full PN. He had elevated direct bilirubin and developed IFALD since 5 weeks. Omegaven treatment was initiated at 5 months. Direct bilirubin rose to 8 mg/dL during the first month on Omegaven. Then a gradual decrease in direct bilirubin was observed, and after 5 months on Omegaven, IFALD was completely resolved. In conclusion, 2 infants with advanced IFALD showed reversal of cholestasis by switching from SMOF to Omegaven monotherapy.

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Section: Discussionmentioning

confidence: 99%

Reversal of Intestinal Failure–Associated Liver Disease by Switching From a Combination Lipid Emulsion Containing Fish Oil to Fish Oil Monotherapy

Lee

Park

Yoon

et al. 2015

J Parenter Enteral Nutr

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“…Hepatic fibrosis persisted after FO treatment, despite improvements of cholestasis. Angsten G et al (JPEN 2012) 22 In a case series of 20 neonates with short bowel disease. Values expressed as multiples of the upper limit of the normal range.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Impact of intravenous lipid emulsions on liver function tests: Contribution of parenteral fish oil

2015

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“…Adding to the cost, investigators may continue FO until PN discontinuation even if direct hyperbilirubinemia has resolved. To date, the longest median follow-up on liver function reported on children who have received FO is 16 months 9 . There is no data on patients whose FO has been discontinued prior to intestinal adaptation, and limited follow-up on subjects after adaptation 2-10 .…”

Section: Introductionmentioning

confidence: 99%

Short-term intravenous fish oil and pediatric intestinal failure associated liver disease: 3-year follow-up on liver function and nutrition

Calkins

Lowe

Shew

et al. 2013

Journal of Pediatric Surgery

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Improved Outcome in Neonatal Short Bowel Syndrome Using Parenteral Fish Oil in Combination With ω‐6/9 Lipid Emulsions

Abstract: Parenteral fish oil in combination with ω-6/9 lipid emulsions was associated with improved outcome in premature neonates with SBS. When used instead of traditional soybean-based emulsions, this mixed lipid emulsion may facilitate intestinal adaptation by increasing the IFALD-free period.

Cited by 56 publications

References 50 publications

Reversal of Intestinal Failure–Associated Liver Disease by Switching From a Combination Lipid Emulsion Containing Fish Oil to Fish Oil Monotherapy

Reversal of Intestinal Failure–Associated Liver Disease by Switching From a Combination Lipid Emulsion Containing Fish Oil to Fish Oil Monotherapy

Impact of intravenous lipid emulsions on liver function tests: Contribution of parenteral fish oil

Short-term intravenous fish oil and pediatric intestinal failure associated liver disease: 3-year follow-up on liver function and nutrition

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