Preventing the Progression of Intestinal Failure–Associated Liver Disease in Infants Using a Composite Lipid Emulsion: A Pilot Randomized Controlled Trial of SMOFlipid

Self Cite

Section: Methodsmentioning

confidence: 99%

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

Lavallee

Lim

Wizzard

et al. 2018

Self Cite

“…Lipid emulsions containing fish oil offer several potential advantages compared with lipid emulsions derived purely from soybean oil, including decreased ω‐6 and increased ω‐3 PUFA content, higher α‐tocopherol levels, and reduced phytosterol content . Studies in PN‐dependent infants and children at risk for IFALD have shown that multi‐component lipid emulsions containing fish oil reduce the risk of cholestasis and improve biochemical measures of hepatobiliary function compared with soybean lipid emulsions …”

Section: Pediatric Patients Requiring Pnmentioning

confidence: 99%

Summary of Proceedings and Expert Consensus Statements From the International Summit “Lipids in Parenteral Nutrition”

Martindale

Berlana

Boullata

et al. 2020

Background The 2018 Lipids in Parenteral Nutrition summit involved a panel of experts in clinical nutrition, lipid metabolism, and pharmacology, to assess the current state of knowledge and develop expert consensus statements regarding the use of intravenous lipid emulsions in various patient populations and clinical settings. The main purpose of the consensus statements is to assist healthcare professionals by providing practical guidance on common clinical questions related to the provision of lipid emulsions as part of parenteral nutrition (PN). Methods The summit was designed to allow interactive discussion and consensus development. The resulting consensus statements represent the collective opinion of the members of the expert panel, which was informed and supported by scientific evidence and clinical experience. Results The current article summarizes the key discussion topics from the summit and provides a set of consensus statements designed to complement existing evidence‐based guidelines. Lipid emulsions are a major component of PN, serving as a condensed source of energy and essential fatty acids. In addition, lipids modulate a variety of biologic functions, including inflammatory and immune responses, coagulation, and cell signaling. A growing body of evidence suggests that lipid emulsions containing ω‐3 fatty acids from fish oil confer important clinical benefits via suppression of inflammatory mediators and activation of pathways involved in the resolution of inflammation. Conclusions This article provides a set of expert consensus statements to complement formal PN guideline recommendations.

“…There have been efforts to prevent or reverse cholestasis by modifying lipid administration in patients requiring long‐term PN. Modifications include lipid minimization, temporarily discontinuing lipids, and using lipid emulsions containing lipid sources other than soybean oil (eg, pure fish oil or composite lipid emulsions with or without fish oil) …”

Section: Lipid Emulsions’ Role In the Treatment And Prevention Of Chomentioning

confidence: 99%

“…Because long‐term use of a pure soybean oil emulsion is a risk factor for cholestasis, both lipid restriction and the use of alternative lipid sources are potential preventative strategies . Studies evaluating the effect of lipid emulsions on the prevention of cholestasis in infants and children are shown in Table …”

Section: Lipid Emulsions’ Role In the Treatment And Prevention Of Chomentioning

confidence: 99%

Lipid Emulsion Use in Pediatric Patients Requiring Long‐Term Parenteral Nutrition

Goulet

Cai

Seo

2020

The ability to deliver nutrients via parenteral nutrition (PN) has markedly improved the prognosis of infants and children with intestinal failure. Technical refinements and advances in knowledge have led to the development of highly sophisticated PN solutions that are tailored to meet the needs of pediatric patients. However, children who require long‐term PN have an increased risk of complications such as catheter‐related sepsis, liver disease, and bone disease. Although the pathogenesis of intestinal failure associated liver disease (IFALD) is multifactorial, studies have identified a possible link between the dose of lipid emulsions based on soybean oil and cholestasis, shown to occur with a significantly higher frequency in patients receiving >1 g lipids/kg/d. Potential contributing factors include oxidative stress, high ω‐6 polyunsaturated fatty acid (PUFA) and phytosterol content, and relatively low α‐tocopherol levels. Lipid emulsions containing fish oil offer potential advantages compared with traditional emulsions with a high soybean oil content, such as decreased ω‐6 and increased ω‐3 PUFA concentrations, high concentrations of α‐tocopherol, and reduced phytosterol content. Studies in PN‐dependent children at risk for IFALD have shown that lipid emulsions containing fish oil reduce the risk of cholestasis and improve biochemical measures of hepatobiliary function compared with pure soybean oil emulsions. This review summarizes evidence regarding the role of lipid emulsions in the management of pediatric patients with intestinal failure requiring long‐term PN, with a particular focus on the prevention and treatment of IFALD.