Liver Disease, Systemic Inflammation, and Growth Using a Mixed Parenteral Lipid Emulsion, Containing Soybean Oil, Fish Oil, and Medium Chain Triglycerides, Compared With Soybean Oil in Parenteral Nutrition–Fed Neonatal Piglets

Abstract

The mixed lipid, having less ω-6 PUFA and more ω-3 PUFA, was able to prevent liver disease and reduce systemic inflammation in PN-fed neonatal piglets. However, this lipid did not increase plasma or brain DHA status, which would be desirable for neonatal developmental outcomes.

Impact of Clinical Use of Parenteral Lipid Emulsions on Bile Acid Metabolism and Composition in Neonatal Piglets

“…As reported, there were no differences in mean age, baseline weight, weight gain, or average PN delivery between SO and FO piglets . Compared with SO, ML piglets weighed more at baseline, and gained more weight each day …”

“…This study and procedures were approved by the University of Alberta Animal Care and Use Committee (AUP#00000153) and performed per the Canadian Council on Animal Care guidelines, in a biosecure swine research facility. The study used samples from piglets studied previously, as published . Sample size and allocations are, therefore, based on these prior studies.…”

“…The piglets were 3–6 days old, male, Large White cross Landrace. Study interventions and methods were previously reported . In brief, PN‐fed piglets had a surgically placed central venous catheter and commenced PN on day 0, with subsequent daily care as reported .…”

“…Using PN‐fed neonatal piglets, a translational model for human neonates, we have previously shown that both pure FO (Omegaven, Fresenius Kabi, Bad Homburg, Germany) and a mixed‐lipid (ML) emulsion containing SO, medium‐chain triglycerides, olive oil, and FO (SMOFlipid, Fresenius Kabi) increased bile flow to high–normal ranges compared with conventional SO (Intralipid, Fresenius Kabi) (normal range = 6.8–12.2, SO = 6.4, ML = 13.0, FO = 13.4 7 µg/g/10 m). The current study investigated the mechanisms for altered bile flow with these FO‐containing lipids in a validated model of PN‐fed human infants and IFALD .…”

Intravenous Lipid Emulsions in Parenteral Nutrition

“…SMOFlipid may have promise as a preventative therapy for PNALD. In a PN-fed neonatal pig model, SMOFlipid was able to prevent PN-associated decreases in bile flow, biochemical evidence of hepatic dysfunction, and increases in inflammatory markers observed with parenteral soybean oil (95). In randomized controlled clinical trials of SMOFlipid, compared with parenteral soybean oil, SMOFlipid improved liver function as measured by g-glutamyl transferase (96) and total bilirubin (97).…”