Association between multioil intravenous lipid emulsion and cholestasis in infants with gastrointestinal disorders: A retrospective cohort study

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-06-03 DOI:10.1002/jpen.2776

Lauren J. Lee MD, MS, Esther S. Kim MD, Tahmineh Romero MS, Kara L. Calkins MD, MS

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引用次数: 0

Abstract

Background

Infants with gastrointestinal (GI) disorders are at risk for parenteral nutrition–associated cholestasis. A multioil intravenous lipid emulsion (MO ILE) contains less phytosterols and more arachidonic and docosahexaenoic acid (DHA) than 100% soybean oil lipid emulsion (SO ILE). This study compares parenteral nutrition–associated cholestasis, growth, and fatty acids in infants with GI disorders who received MO ILE or SO ILE.

Methods

This retrospective cohort study included 48 infants with GI disorders born between 2014 and 2022 who received an intravenous lipid emulsion for ≥14 days. Cholestasis was defined as serum conjugated bilirubin ≥2 mg/dl; growth was assessed by z score changes. Gas chromatography and mass spectrometry was used to measure fatty acid content in the erythrocyte cell membrane.

Results

The incidence of parenteral nutrition–associated cholestasis was similar (MO ILE 30% vs SO ILE 29%, P > 0.99). However, compared with infants who received parenteral nutrition >28 days and SO ILE, infants who received parenteral nutrition >28 days and MO ILE experienced a slower rise in conjugated bilirubin (0.1 ± 0.03 vs 0.26 ± 0.38 mg/dl, P interaction < 0.001). Weight z score decline (discharge to birth) was less in the MO ILE group vs SO ILE group (−1.0 [−2.0, −0.4] vs −0.4 [−0.9, 0], P = 0.04). Although the MO ILE group demonstrated improved DHA status at weeks 1–3 (P < 0.05 for all), arachidonic acid and DHA decreased over time in both groups and there was no difference in the rate of change (P interaction > 0.3 for both).

Conclusion

In infants with GI disorders, MO ILE was associated with improved growth. MO ILE was well tolerated and hepatoprotective in infants who required prolonged parenteral nutrition.

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多油静脉注射脂质乳剂与胃肠道疾病婴儿胆汁淤积的关系：一项回顾性队列研究。

背景：患有胃肠道疾病的婴儿有肠外营养相关性胆汁淤积的风险。多油静脉注射脂质乳（MO ILE）比100%大豆油脂质乳（SO ILE）含有更少的植物甾醇和更多的花生四烯酸和二十二碳六烯酸（DHA）。本研究比较了接受MO ILE或SO ILE的胃肠道疾病婴儿肠外营养相关的胆汁淤积、生长和脂肪酸。方法：本回顾性队列研究纳入了48例2014年至2022年出生的胃肠道疾病婴儿，接受静脉注射脂质乳剂≥14天。胆汁淤积定义为血清结合胆红素≥2 mg/dl；生长通过z分数变化来评估。采用气相色谱-质谱法测定红细胞膜脂肪酸含量。结果：肠外营养相关性胆汁淤积的发生率相似（MO ILE 30% vs SO ILE 29%, P < 0.99）。然而，与接受肠外营养>28天和SO ILE的婴儿相比，接受肠外营养>28天和MO ILE的婴儿共轭胆红素升高较慢（0.1±0.03 vs 0.26±0.38 mg/dl，两者的相互作用P为0.3）。结论：在患有胃肠道疾病的婴儿中，MO ILE与生长改善有关。对于需要长时间肠外营养的婴儿，MO ILE具有良好的耐受性和肝脏保护作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Parenteral and Enteral Nutrition 医学-营养学

CiteScore

7.80

自引率

8.80%

发文量

161

审稿时长

6-12 weeks

期刊介绍： The Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or IV therapies. Also included: reviews, techniques, brief reports, case reports, and abstracts.