Parenteral nutrition with fish oil-based lipid emulsion reduces the risk of cholestasis in preterm infants

Abstract

Objective Preterm infants receive long-term parenteral nutrition (PN) for gastrointestinal immaturity. This study aimed to determine if mixed lipid emulsions containing fish oil decrease the incidence of PN-associated cholestasis by reducing oxidative stress and providing an anti-inflammatory effect. Methods This retrospective cohort study enrolled 399 very low birth weight premature infants (gestational age ≤32 weeks) between January 2009 and November 2017 at a single neonatal intensive care unit. Preterm infants received total PN with either mixed lipid emulsion including fish oil (SMOFlipid®, n = 195) or soybean oil-based lipid emulsion (Lipovenoes®, n = 204) for at least 7 days. We compared the outcomes of PN-associated cholestasis, comorbidities, and mortality between the groups. Results The incidence of PN-associated cholestasis was significantly lower in the SMOFlipid group than in the Lipovenoes group. The duration to full feeding days was significantly shorter in the SMOFlipid group compared with the Lipovenoes group. Relevant complications, such as severe retinopathy of prematurity and bronchopulmonary dysplasia, were also significantly reduced in the SMOFlipid group compared with the Lipovenoes group. Conclusion In premature infants, PN with fish oil-based lipid emulsions is associated with a lower incidence of PN-associated cholestasis compared with soybean oil-based lipid emulsions.

Lipid emulsions in parenteral nutrition: does it matter?

“…An added benefit of the omega-3 fatty acid ILEs found in FO is that they increase learning, memory, cognitive well being, and blood flow to the brain [38 ▪ ]. It is also clearly proven that pure FO-LE in PN reduce, and in fact can reverse, the occurrence of cholestasis in very low birth weight and preterm infants [5 ▪▪ ,39 ▪▪ ,40 ▪ ,41].…”