Essential Fatty Acid Status in Surgical Infants Receiving Parenteral Nutrition With a Composite Lipid Emulsion: A Case Series

JPEN. Journal of Parenteral and Enteral Nutrition
Alexandra N CareyMark Puder

Abstract

Infants requiring prolonged parenteral nutrition (PN) may receive intravenous (IV) lipid in the form of soybean oil, fish oil, or a composite lipid emulsion (CLE) (i.e., SMOFlipid®). Soybean oil lipid-dose restriction is a popular method of treating and reducing the risk of intestinal failure-associated liver disease (IFALD) that may influence dosing strategies of other IV fat emulsions. Here we present 4 infants receiving PN with SMOFlipid® as their IV lipid source and examine trends in essential fatty-acid status, triglycerides, and dosing strategy. The infants on restricted doses of CLE developed biochemical essential fatty-acid deficiency (EFAD) that resolved with a dosage increase or by transition to a pure fish-oil lipid emulsion. Three of the 4 infants originally prescribed CLE were diagnosed with IFALD and started a pure fish-oil lipid emulsion after treatable causes of cholestasis were excluded. One of the 4 infants presented with hypertriglyceridemia that resolved upon transition to pure fish-oil lipid emulsion. Misapplication of lipid restriction protocols to CLE regimens render infants at risk for EFAD. CLE should be dosed within recommended ranges to prevent EFAD. Restricted protocols warrant close monitoring of es...Continue Reading

References

Nov 1, 1972·The Journal of Pediatrics·M D CaldwellH B Othersen
Mar 10, 1998·Pediatric Clinics of North America·J P Balint
Oct 11, 2011·The Journal of Pediatrics·Mary Petrea CoberDaniel H Teitelbaum
Jan 23, 2016·The American Journal of Clinical Nutrition·Prathima NandivadaMark Puder
Jul 19, 2017·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Lorenzo Anez-BustillosMark Puder
Nov 22, 2017·JPEN. Journal of Parenteral and Enteral Nutrition·Manpreet S MundiRyan T Hurt

❮ Previous
Next ❯

Citations

Sep 25, 2019·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Kathleen M GuraMark Puder
Feb 1, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Racha T Khalaf, Ronald J Sokol
May 28, 2020·Journal of Pediatric Gastroenterology and Nutrition·Jason A SilvermanPaul W Wales
May 18, 2020·JPEN. Journal of Parenteral and Enteral Nutrition·Beatrice E HoDanielle Wendel
May 28, 2020·JPEN. Journal of Parenteral and Enteral Nutrition·Katie A HuffCharles Vanderpool
Dec 29, 2020·Expert Opinion on Drug Safety·Jordan D SecorKathleen M Gura
Dec 3, 2020·Journal of Pediatric Gastroenterology and Nutrition·Bram P RaphaelMark Puder
Apr 17, 2021·Current Gastroenterology Reports·Danielle WendelValeria C Cohran
Sep 29, 2021·The American Journal of Clinical Nutrition·Olivier GouletCécile Lambe
Oct 28, 2021·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·M Petrea CoberUNKNOWN ASPEN Parenteral Nutrition Safety Committee

❮ Previous
Next ❯

Related Concepts

Related Feeds

Barrett Esophagus

Barrett’s esophagus if a serious complication of gastroesophageal reflux disease during which the normal esophageal lining changes to tissue that resembles intestinal lining. Here is the latest research.