Intravenous fat emulsions reduction for patients with parenteral nutrition-associated liver disease.

Abstract

OBJECTIVE:

To test the hypothesis that implementation of a marked reduction in intravenous fat will result in reversal of parenteral nutrition-associated liver disease (PNALD) in infants.

STUDY DESIGN:

Prospective study of intravenous fat emulsion reduction in parenteral nutrition to 1 g/kg/d 2 times per week in neonates diagnosed with PNALD. Primary outcome measure was total bilirubin levels compared with gestational age, birth weight, and diagnosis-matched historical controls receiving 3 g/kg/d of intravenous lipids.

RESULTS:

Intravenous fat emulsion reduction resulted in a significant decline in total bilirubin levels compared with controls. Comparison of growth in the 2 groups was similar. Mild essential fatty acid deficiency was detected in 8 of 31 infants and was reversed with additional days of lipid infusion. No significant adverse events were noted.

CONCLUSIONS:

An association between intravenous lipid emulsion administration and the development of PNALD seems probable. Use of intravenous fat emulsion reduction is a potential approach to reverse PNALD in young infants. Frequent monitoring of essential fatty acid deficiency is needed with the use of this regimen.

• Authors: Mary Petrea Cober, Ghassan Killu, Allison Brattain, Kathleen B Welch, Shaun M Kunisaki, Daniel H Teitelbaum
• Journal: The Journal of pediatrics (J Pediatr) Vol. 160 Issue 3 Pg. 421-7 (Mar 2012) ISSN: 1097-6833 [Electronic] United States
• PMID: 21982303 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Mosby, Inc. All rights reserved.

Chemical References

• Fat Emulsions, Intravenous
• Fatty Acids, Essential
• Bilirubin

Topics

• Bilirubin (blood)
• Cholestasis (blood, etiology, therapy)
• Fat Emulsions, Intravenous (administration & dosage, adverse effects)
• Fatty Acids, Essential (deficiency)
• Female
• Humans
• Infant, Newborn
• Liver Diseases (blood, etiology, therapy)
• Male
• Parenteral Nutrition (adverse effects)