Influence of Different Intravenous Lipid Emulsions on Hepatobiliary Dysfunction in a Rabbit Model

Abstract

In our animal model, the use of a lipid emulsion with a reduced amount of polyunsaturated fatty acids was not superior to a lipid emulsion based on soybean oil. Long-term application of n-3 fatty acids was associated with more extensive fibrosis. Therefore, intravenous n-3 fatty acids containing lipid preparations (fish oil) should not be used in patients for long-term TPN.

Is the use of parenteral ω-3 lipid emulsions justified in surgical neonates with mild parenteral nutrition–associated liver dysfunction?

“…To our knowledge, there have been no other reports of this association. Hepatic fibrosis has also been described in an animal model using O-3 fatty acid [20], as well as a report of 2 cases of progressive fibrosis in children receiving Omegaven despite biochemical normalization [21]. However, these clinical data are difficult to interpret because the natural history of liver fibrosis after PNALD is poorly understood and that liver biopsies are rarely performed in the setting of biochemical resolution of PNALD.…”

The association of cyclic parenteral nutrition and decreased incidence of cholestatic liver disease in patients with gastroschisis

“…A number of pharmacologic therapies have been advocated, with mixed results [12,13]. Parenteral nutrition factors, specifically amino acid composition and lipid formulation, have also demonstrated mixed results [7,[14][15][16][17][18]. Case reports have suggested that the use of ω-3 fatty acid-based lipid formulations may improve hyperbilirubinemia, but studies performed in animal models suggest that this may be associated with increased hepatic fibrosis, despite normal biochemical markers [15,16].…”

“…Parenteral nutrition factors, specifically amino acid composition and lipid formulation, have also demonstrated mixed results [7,[14][15][16][17][18]. Case reports have suggested that the use of ω-3 fatty acid-based lipid formulations may improve hyperbilirubinemia, but studies performed in animal models suggest that this may be associated with increased hepatic fibrosis, despite normal biochemical markers [15,16]. Perhaps of greatest protective benefit is initiation of full enteral feeding and withdrawal of PN, which have been associated with resolution of hyperbilirubinemia [19].…”

Recent advances in the management of intestinal failure-associated liver disease

“…Furthermore, omega-3 fatty acids appear to stimulate mitochondrial fatty acid oxidation leaving less substrate for triacylglycerol synthesis [46 ] and have been shown to reduce steatosis in a murine model [52]. A word of caution was introduced in a rabbit model showing increased fibrosis with omega-3 lipid supplementation [53]; however, all treatment groups in this study showed hepatic fibrosis, and the degree of supplementation with fish oil in this treatment arm was small. Clearly, however, some omega-6 fatty acid is required to prevent essential fatty acid deficiency.…”