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Resolution of parenteral nutrition-associated jaundice on changing from a soybean oil emulsion to a complex mixed-lipid emulsion.
J Pediatr Gastroenterol Nutr 2012; 54(6):797-802JP

Abstract

BACKGROUND AND OBJECTIVE

Resolution of parenteral nutrition (PN)-associated jaundice has been reported in children given a reduced dose of intravenous fat using a fish oil-derived lipid emulsion. The aim of the present study was to examine the effect on PN-associated jaundice of changing from a soybean oil-derived lipid to a mixed lipid emulsion derived from soybean, coconut, olive, and fish oils without reducing the total amount of lipid given.

METHODS

Retrospective cohort comparison examining serum bilirubin during 6 months in children with PN-associated jaundice who changed to SMOFlipid (n=8) or remained on Intralipid (n=9).

RESULTS

At entry, both groups received most of their energy as PN (SMOFlipid 81.5%, range 65.5-100 vs Intralipid 92.2%, range 60.3-100; P=0.37). After 6 months, both tolerated increased enteral feeding but still received large proportions of their energy as PN (SMOFlipid 68.4%, range 36.6-100 vs Intralipid 50%, range 37.6-76; P=0.15). The median bilirubin at the outset was 143 μmol/L (range 71-275) in the SMOFlipid group and 91 μmol/L (range 78-176) in the Intralipid group. After 6 months, 5 of 8 children in the SMOFlipid and 2 of 9 children in the Intralipid group had total resolution of jaundice. The median bilirubin fell by 99 μmol/L in the SMOFlipid group but increased by 79 μmol/L in the Intralipid group (P=0.02).

CONCLUSIONS

SMOFlipid may have important protective properties for the liver and may constitute a significant advance in PN formulation. Randomised trials are needed to study the efficacy of SMOFlipid in preventing PN liver disease.

Authors+Show Affiliations

Department of Paediatric Gastroenterology, University of Birmingham, Birmingham, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22157927

Citation

Muhammed, Rafeeq, et al. "Resolution of Parenteral Nutrition-associated Jaundice On Changing From a Soybean Oil Emulsion to a Complex Mixed-lipid Emulsion." Journal of Pediatric Gastroenterology and Nutrition, vol. 54, no. 6, 2012, pp. 797-802.
Muhammed R, Bremner R, Protheroe S, et al. Resolution of parenteral nutrition-associated jaundice on changing from a soybean oil emulsion to a complex mixed-lipid emulsion. J Pediatr Gastroenterol Nutr. 2012;54(6):797-802.
Muhammed, R., Bremner, R., Protheroe, S., Johnson, T., Holden, C., & Murphy, M. S. (2012). Resolution of parenteral nutrition-associated jaundice on changing from a soybean oil emulsion to a complex mixed-lipid emulsion. Journal of Pediatric Gastroenterology and Nutrition, 54(6), pp. 797-802. doi:10.1097/MPG.0b013e3182447daf.
Muhammed R, et al. Resolution of Parenteral Nutrition-associated Jaundice On Changing From a Soybean Oil Emulsion to a Complex Mixed-lipid Emulsion. J Pediatr Gastroenterol Nutr. 2012;54(6):797-802. PubMed PMID: 22157927.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resolution of parenteral nutrition-associated jaundice on changing from a soybean oil emulsion to a complex mixed-lipid emulsion. AU - Muhammed,Rafeeq, AU - Bremner,Ronald, AU - Protheroe,Sue, AU - Johnson,Tracey, AU - Holden,Chris, AU - Murphy,M Stephen, PY - 2011/12/14/entrez PY - 2011/12/14/pubmed PY - 2012/9/5/medline SP - 797 EP - 802 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 54 IS - 6 N2 - BACKGROUND AND OBJECTIVE: Resolution of parenteral nutrition (PN)-associated jaundice has been reported in children given a reduced dose of intravenous fat using a fish oil-derived lipid emulsion. The aim of the present study was to examine the effect on PN-associated jaundice of changing from a soybean oil-derived lipid to a mixed lipid emulsion derived from soybean, coconut, olive, and fish oils without reducing the total amount of lipid given. METHODS: Retrospective cohort comparison examining serum bilirubin during 6 months in children with PN-associated jaundice who changed to SMOFlipid (n=8) or remained on Intralipid (n=9). RESULTS: At entry, both groups received most of their energy as PN (SMOFlipid 81.5%, range 65.5-100 vs Intralipid 92.2%, range 60.3-100; P=0.37). After 6 months, both tolerated increased enteral feeding but still received large proportions of their energy as PN (SMOFlipid 68.4%, range 36.6-100 vs Intralipid 50%, range 37.6-76; P=0.15). The median bilirubin at the outset was 143 μmol/L (range 71-275) in the SMOFlipid group and 91 μmol/L (range 78-176) in the Intralipid group. After 6 months, 5 of 8 children in the SMOFlipid and 2 of 9 children in the Intralipid group had total resolution of jaundice. The median bilirubin fell by 99 μmol/L in the SMOFlipid group but increased by 79 μmol/L in the Intralipid group (P=0.02). CONCLUSIONS: SMOFlipid may have important protective properties for the liver and may constitute a significant advance in PN formulation. Randomised trials are needed to study the efficacy of SMOFlipid in preventing PN liver disease. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/22157927/Resolution_of_parenteral_nutrition_associated_jaundice_on_changing_from_a_soybean_oil_emulsion_to_a_complex_mixed_lipid_emulsion_ L2 - http://Insights.ovid.com/pubmed?pmid=22157927 DB - PRIME DP - Unbound Medicine ER -