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Intralipid and preterm

Thomas Hegyi, Alan Kleinfeld, Andrew Huber, Barry Weinberger, Naureen Memon, Weichung Joe Shih, Mary Carayannopoulos, William Oh
OBJECTIVE: To determine the plasma triglyceride (TG) and unbound free fatty acid (FFAu) levels in infants treated with increasing dosages of soybean lipid, intralipid (IL), infusion. STUDY DESIGN: TG and FFAu levels were measured in 78 preterm infants (BW 500-2000 g; GA 23-34 weeks) using the fluorescent probe ADIFAB2 and enzymatic method. RESULTS: The infants' BW was 1266.2 ± 440.7 g and GA 28.8 ± 3.1 weeks. TG levels were 77.4 ± 50 mg/dL, 140...
April 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
Nalin Choudhary, Kenneth Tan, Atul Malhotra
Neonatal units have started to switch from using conventional soy-based to alternate lipid emulsions, like SMOFlipid. SMOFlipid has been associated with an improvement in biochemical parameters and delays progression of parenteral nutrition-associated liver disease (PNALD). This retrospective epoch study aimed to compare clinically relevant neonatal outcomes in preterm infants (< 32 weeks), receiving SMOFlipid versus Intralipid. We compared clinical outcomes in two epochs-epoch 1 (Intralipid, October 2013-June 2015) versus epoch 2 (SMOFlipid, July 2015-March 2017)...
May 2018: European Journal of Pediatrics
Christoph Binder, Nicholas Longford, Chris Gale, Neena Modi, Sabita Uthaya
BACKGROUND: The optimal nutritional regimen for preterm infants, including those that develop necrotising enterocolitis (NEC), is unknown. OBJECTIVE: The objective here was to evaluate body composition at term in infants following NEC, in comparison with healthy infants. The primary outcome measure was non-adipose tissue mass (non-ATM). METHODS: We compared body composition assessed by magnetic resonance imaging at term in infants born <31 weeks of gestational age that participated in NEON, a trial comparing incremental versus immediate delivery of parenteral amino acids on non-ATM, and SMOF versus intralipid on intrahepatocellular lipid content...
2018: Neonatology
Thomas Hegyi, Alan Kleinfeld, Andrew Huber, Barry Weinberger, Naureen Memon, Weichung Joe Shih, Mary Carayannopoulos, William Oh
OBJECTIVE: To assess the effects of a soybean lipid emulsion infusions on levels of unbound (free) bilirubin (Bf) and unbound free fatty acids (FFAu) as well as changes in Bf and total serum bilirubin (TSB) during phototherapy in infants born preterm. STUDY DESIGN: Ninety-seven infants born preterm (birth weight: 500-2000 g; gestational age: 23-34 weeks) were enrolled to investigate the effect of 0, 1, 2, and 3 g/kg/d of intralipid infusion on Bf and FFAu. Pre- and postphototherapy TSB, FFAu, and Bf also were analyzed in 91 infants to assess the effects of phototherapy...
May 2017: Journal of Pediatrics
Justine M Turner, Yves Sauvé, Miyoung Suh, Paul W Wales, Pamela Wizzard, Susan Goruk, Catherine J Field
BACKGROUND: Preterm neonates and those with intestinal failure require prolonged parenteral nutrition (PN) during a critical time of early central nervous system maturation. Conventional lipid emulsions fed to preterm neonates lack n-3 (ω-3) long-chain polyunsaturated fatty acids (LC-PUFAs; >20 carbon chain in length). Recently, fish oil lipid emulsions have been developed that provide both n-6 (ω-6) and n-3 LC-PUFAs, precursors of very long-chain PUFAs (VLC-PUFAs; >24 carbon chain in length)...
November 2016: Journal of Nutrition
Gregory Guthrie, Madhulika Kulkarni, Hester Vlaardingerbroek, Barbara Stoll, Kenneth Ng, Camilia Martin, John Belmont, Darryl Hadsell, William Heird, Christopher B Newgard, Oluyinka Olutoye, Johannes van Goudoever, Charlotte Lauridsen, Xingxuan He, Edward H Schuchman, Douglas Burrin
We aimed to characterize the lipidomic, metabolomic, and transcriptomic profiles in preterm piglets administered enteral (ENT) formula or three parenteral lipid emulsions [parenteral nutrition (PN)], Intralipid (IL), Omegaven (OV), or SMOFlipid (SL), for 14 days. Piglets in all parenteral lipid groups showed differential organ growth versus ENT piglets; whole body growth rate was lowest in IL piglets, yet there were no differences in either energy expenditure or (13)C-palmitate oxidation. Plasma homeostatic model assessment of insulin resistance demonstrated insulin resistance in IL, but not OV or SL, compared with ENT...
September 2016: Journal of Lipid Research
Kenneth Ng, Barbara Stoll, Shaji Chacko, Miguel Saenz de Pipaon, Charlotte Lauridsen, Matthew Gray, E James Squires, Juan Marini, Irving J Zamora, Oluyinka O Olutoye, Douglas G Burrin
INTRODUCTION: Parenteral nutrition (PN) in preterm infants leads to PN-associated liver disease (PNALD). PNALD has been linked to serum accumulation of phytosterols that are abundant in plant oil but absent in fish oil emulsions. HYPOTHESIS: Whether modifying the phytosterol and vitamin E composition of soy and fish oil lipid emulsions affects development of PNALD in preterm pigs. METHODS: We measured markers of PNALD in preterm pigs that received 14 days of PN that included 1 of the following: (1) Intralipid (IL, 100% soybean oil), (2) Intralipid + vitamin E (ILE, d-α-tocopherol), (3) Omegaven (OV, 100% fish oil), or (4) Omegaven + phytosterols (PS, β-sitosterol, campesterol, and stigmasterol)...
July 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Thomas Hegyi, Suganya Kathiravan, Gary E Stahl, Andrew H Huber, Alan Kleinfeld
Extremely low birth weight (ELBW; <1,000 g) infants have poor outcomes, often compromised by bilirubin neurotoxicity. We measured unbound bilirubin (Bf) and unbound free fatty acid (FFAu) levels in 5 ELBW infants in a trial examining the effects of pharmacologic ductal closure on infants treated with Intralipid infusion (3 g/kg/day). The levels for all infants (mean ± SD) were: total serum bilirubin (TSB) 4.6 ± 1.7 mg/dl, FFAu 376 ± 496 nM, and Bf 42 ± 30 nM. Of the 3 infants who died, 2 had TSB <5...
2013: Neonatology
Dorota Pawlik, Ryszard Lauterbach, Maria Walczak, Joanna Hurkała, Michael P Sherman
BACKGROUND: Preliminary studies suggest that fish-oil lipid emulsion given parenterally to very preterm infants reduces the severity of retinopathy (ROP) and cholestasis. METHODS: Infants weighing <1250 g at birth were randomly allocated to 2 groups: an experimental group of 60 infants that received an intravenous (IV) soybean, olive oil, and fish oil emulsion, and a control group of 70 infants that was given a parenteral soybean and olive oil emulsion. Plasma and erythrocyte concentrations of docosahexaenoic acid (DHA) were determined using a high-performance liquid chromatography-mass spectrometry analysis...
August 2014: JPEN. Journal of Parenteral and Enteral Nutrition
Maria Skouroliakou, Dimitris Konstantinou, Charalampos Agakidis, Natalia Delikou, Katerina Koutri, Marina Antoniadi, Thomais Karagiozoglou-Lampoudi
BACKGROUND: This study aimed to compare the effect of 2 lipid emulsions (LEs), a medium-chain triglyceride (MCT)/ω-3-polyunsaturated fatty acid (PUFA)-containing LE and a soybean-based LE, on the incidence of neonatal cholestasis, bronchopulmonary dysplasia (BPD), and lipid profile of preterm infants. Patients and METHODS: In this prospective, observational study, 2 groups of preterm neonates, the very low birth weight (VLBW) (n = 129) and the low birth weight (LBW) groups (n = 153), which received parenteral LEs for at least 7 days, were included...
December 2012: Nutrition in Clinical Practice
Adam J Lewandowski, Merzaka Lazdam, Esther Davis, Ilias Kylintireas, Jonathan Diesch, Jane Francis, Stefan Neubauer, Atul Singhal, Alan Lucas, Brenda Kelly, Paul Leeson
OBJECTIVE: Intravenous lipid use is associated with an acute hyperlipidemia, but long-term consequences have not been studied. We investigated whether elevated lipids in humans during the critical period of preterm neonatal life have a long-term impact on aortic and myocardial function relevant to adult disease. METHODS AND RESULTS: We followed up 102 subjects born prematurely and now aged 23 to 28 years. Eighteen received intravenous lipids as neonates and were matched to controls with equivalent perinatal characteristics...
September 2011: Arteriosclerosis, Thrombosis, and Vascular Biology
A R Barclay, L M Beattie, L T Weaver, D C Wilson
BACKGROUND: Intestinal failure (IF) affects a growing number of children due to increasing numbers of preterm infants surviving intestinal resection for necrotising enterocolitis and improving surgical techniques for congenital gut anomalies. Parenteral nutrition (PN) is the mainstay of therapy; enteral nutrition may have trophic effects on the gut. AIM: To review systematically evidence for the effectiveness of medical and nutritional interventions in the treatment of IF in children...
January 2011: Alimentary Pharmacology & Therapeutics
M Skouroliakou, D Konstantinou, K Koutri, C Kakavelaki, M Stathopoulou, M Antoniadi, N Xemelidis, V Kona, S Markantonis
BACKGROUND/OBJECTIVES: The aim of this study was to research and draw conclusions about the effect of a parenteral nutrition (PN) fat emulsion, rich in omega-3 fatty acids, on the antioxidant markers of preterm infants, when compared with a standard fat emulsion. This was a double-blind, parallel-group study conducted in Athens, Greece, using an equal randomization method. SUBJECTS/METHODS: Thirty-eight infants were selected using a double-blind method and a computer-generated randomization list...
September 2010: European Journal of Clinical Nutrition
Anne A M W van Kempen, Saskia N van der Crabben, Mariëtte T Ackermans, Erik Endert, Joke H Kok, Hans P Sauerwein
In preterm infants, both hypo- and hyperglycemia are a frequent problem. Intravenous lipids can affect glucose metabolism by stimulation of gluconeogenesis by providing glycerol, which is a gluconeogenic precursor, and/or free fatty acids (FFA), which are stimulants of the rate of gluconeogenesis. In 25 preterm infants, glucose production and gluconeogenesis were measured using stable isotope techniques during a 6-h infusion of glucose only, glucose plus glycerol, or glucose plus an intravenous lipid emulsion...
April 2006: American Journal of Physiology. Endocrinology and Metabolism
Ulf Kessler, Zacharias Zachariou, Dorothea Raz, Johannes Poeschl, Otwin Linderkamp
Deleterious microcirculatory effects of Intralipid (IL) infusion may be caused by hemorheological or vascular effects. The aim of this investigation was to study vascular and hemorheological effects of IL in preterm and fullterm neonates and children. Ten preterm newborns, 10 fullterm neonates, and 10 children received an initial infusion of IL (0.6 g/kg) over 4 h. Calf blood flow (venous occlusion plethysmography), blood pressure (Dinamap), whole blood and plasma viscosity (capillary viscometer), red blood cell deformability (rheoscope), and erythrocyte aggregation (aggregometer) were measured before and after administration of IL...
March 2005: Pediatric Surgery International
U Kessler, J Poeschl, D Raz, O Linderkamp, J Bauer
AIM: To study acute haemorheological effects of intralipid in preterm and full-term neonates and children. Circulatory complications of intralipid infusion, such as increases in pulmonary and peripheral flow resistance, have been associated with impaired blood rheology. METHODS: During total parenteral nutrition, 10 preterm infants, 10 full-term neonates and 10 children received an initial dose of intralipid as continuous infusion (0.6 g/kg) over 4 h. Additionally, blood of 10 healthy preterm infants, 10 full-term neonates and 10 adults was incubated with intralipid...
August 2004: Acta Paediatrica
A L Magnusson, I J Waterman, M Wennergren, T Jansson, T L Powell
Triglyceride (TG) hydrolases in the placental microvillous plasma membrane (MVM) release fatty acids from circulating lipoproteins and represent the critical initial step in transplacental fatty acid transfer. We investigated the activity of two TG hydrolases in MVM isolated from placentas of appropriately grown for gestational age pregnancies and pregnancies complicated by intrauterine growth restriction (IUGR), insulin-dependent diabetes mellitus (IDDM) or gestational diabetes mellitus (GDM). In addition, we measured protein expression of lipoprotein lipase (LPL) in MVM and two fatty acid binding proteins (L- and C-FABP) in placental homogenates...
September 2004: Journal of Clinical Endocrinology and Metabolism
Hassan M Ibrahim, Majied A Jeroudi, R J Baier, Ramasubbareddy Dhanireddy, Richard W Krouskop
OBJECTIVE: This study aimed to compare nitrogen balance and biochemical tolerance of early aggressive versus late total parenteral nutrition in very-low-birth-weight (VLBW) infants over the first week of life. STUDY DESIGN: In all, 32 ventilator-dependent preterm infants were prospectively randomized into two groups. The Early Total Parenteral Nutrition (ETPN) group received 3.5 g/kilo-day amino acids (AA), and 3 g/kilo-day of 20% Intralipid (IL), starting within 1 hour after birth...
August 2004: Journal of Perinatology: Official Journal of the California Perinatal Association
Peter J Porcelli, Harry Greene, Eugene Adcock
INTRODUCTION: Very-low-birth-weight (VLBW; birth weight, <1,500 g) infants receive preterm infant formulas and parenteral multivitamin preparations that provide more riboflavin (vitamin B2) than does human milk and more than that recommended by the American Society of Clinical Nutrition. VLBW infants who are not breast-fed may have plasma riboflavin concentrations up to 50 times higher than those in cord blood. The authors examined a vitamin regimen designed to reduce daily riboflavin intake, with the hypothesis that this new regimen would result in lower plasma riboflavin concentrations while maintaining lipid-soluble vitamin levels...
April 2004: Journal of Pediatric Gastroenterology and Nutrition
R B Knobel, W Meetze, J Cummings
A preterm infant, whose course was complicated by sepsis, necrotizing enterocolitis with jejunal perforation, intraventricular hemorrhage and cerebellar hemorrhage, suffered permanent and total paralysis below the neck from extravasation of parenteral nutrition fluids through a femoral venous catheter. MRI imaging revealed extravasation of fluid into the paraspinus musculature with extension into the spinal canal. This fluid was identified as hyperalimentation and intralipid. Postmortem examination found evidence of necrosis of the spinal cord as well as perforation of the right iliac vein...
January 2001: Journal of Perinatology: Official Journal of the California Perinatal Association
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