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Parenteral fish oil and infant

Michael Sorrell, Alvaro Moreira, Kay Green, Rachel Jacobs, Robin Tragus, Laura Keller, Amy Quinn, Donald McCurnin, Alice Gong, Abeer El Sakka, Naveen Mittal, Cynthia Blanco
OBJECTIVES: To study the acute and long-term outcomes of preterm infants treated with an intravenous (IV) fish oil-based lipid emulsion (FishLE) for parenteral nutrition-associated liver disease (PNALD). METHODS: Preterm infants 14 days to 24 months of age with anatomic short gut or severe intestinal dysmotility, serum direct bilirubin ≥4 mg/dL, and requiring >60% calories from PN were eligible. Enrolled infants received 1 g/kg/day of FishLE until resolution of direct hyperbilirubinemia or return of enteral nutrition...
August 27, 2016: Journal of Pediatric Gastroenterology and Nutrition
Prathima Nandivada, Meredith A Baker, Paul D Mitchell, Alison A O'Loughlin, Alexis K Potemkin, Lorenzo Anez-Bustillos, Sarah J Carlson, Duy T Dao, Gillian L Fell, Kathleen M Gura, Mark Puder
BACKGROUND: Parenteral fish-oil (FO) therapy is a safe and effective treatment for intestinal failure-associated liver disease (IFALD). Patients whose cholestasis does not resolve with FO may progress to end-stage liver disease. OBJECTIVE: We sought to identify factors associated with the failure of FO therapy in treating IFALD to guide prognostication and referral guidelines. DESIGN: Prospectively collected data for patients treated with FO at Boston Children's Hospital from 2004 to 2014 were retrospectively reviewed...
September 2016: American Journal of Clinical Nutrition
Mary Riedy, Brittany DePaula, Mark Puder, Kathleen M Gura, Kevin A Sztam
Fish oil-based lipid emulsions (FOLEs) have been used to treat cholestasis in children with intestinal failure-associated liver disease (IFALD). When FOLEs are dosed at 1 g/kg/d, essential fatty acid (EFA) deficiency typically does not occur. We describe the clinical course of a severely malnourished parenteral nutrition-dependent infant with IFALD. Baseline EFA panels were normal upon starting FOLE at 1 g/kg/d. Despite biochemical improvement in IFALD, weight velocity was below target and biochemical EFA status worsened, even after correction for other factors affecting weight...
August 1, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Brian J Strang, Bruce A Reddix, Robert A Wolk
BACKGROUND: Parenteral nutrition-associated cholestasis (PNAC) and liver disease have been associated with soybean oil-based intravenous fat emulsions (IVFEs). The benefit of fish oil-based IVFEs in the reversal of parenteral nutrition (PN)-associated liver damage includes allowing for longer PN duration without immediate need for bowel or liver transplantation. METHODS: The present case involves an infant born with short bowel syndrome (SBS) requiring long-term PN with development of PNAC and subsequent administration of a fish oil-based IVFE...
October 2016: Nutrition in Clinical Practice
Leilei Wang, Jing Zhang, Jiejin Gao, Yan Qian, Ya Ling
Purpose. To retrospectively study the effect of fish oil-based lipid emulsion and soybean oil-based lipid emulsion on cholestasis associated with long-term parenteral nutrition in premature infants. Methods. Soybean oil-based lipid emulsion and fish oil-based lipid emulsion had been applied in our neonatology department clinically between 2010 and 2014. There were 61 qualified premature infants included in this study and divided into two groups. Soybean oil group was made up of 32 premature infants, while fish oil group was made up of 29 premature infants...
2016: Gastroenterology Research and Practice
Sabita Uthaya, Xinxue Liu, Daphne Babalis, Caroline J Doré, Jane Warwick, Jimmy Bell, Louise Thomas, Deborah Ashby, Giuliana Durighel, Ash Ederies, Monica Yanez-Lopez, Neena Modi
BACKGROUND: Parenteral nutrition is central to the care of very immature infants. Current international recommendations favor higher amino acid intakes and fish oil-containing lipid emulsions. OBJECTIVE: The aim of this trial was to compare 1) the effects of high [immediate recommended daily intake (Imm-RDI)] and low [incremental introduction of amino acids (Inc-AAs)] parenteral amino acid delivery within 24 h of birth on body composition and 2) the effect of a multicomponent lipid emulsion containing 30% soybean oil, 30% medium-chain triglycerides, 25% olive oil, and 15% fish oil (SMOF) with that of soybean oil (SO)-based lipid emulsion on intrahepatocellular lipid (IHCL) content...
June 2016: American Journal of Clinical Nutrition
Hyon Hui Lee, Ji Mi Jung, So-Hyun Nam, Gina Lim, Mi Lim Chung
AIM: Parenteral nutrition (PN) provides an alternative nutrition source for preterm infants who are intolerant of enteral nutrition. However, prolonged PN increases the risk of PN-associated cholestasis (PNAC). We conducted this study to determine the incidence and risk factors of PNAC in extremely low birth weight (ELBW) infants. METHODS: We retrospectively reviewed the medical records of ELBW infants from March 2010 to April 2015. PNAC was diagnosed in infants with a history of PN for at least two weeks and direct bilirubin concentrations >2 mg/dL after other causes of neonatal cholestasis were excluded...
July 2016: Acta Paediatrica
Prathima Nandivada, Gillian L Fell, Paul D Mitchell, Alexis K Potemkin, Alison A O'Loughlin, Kathleen M Gura, Mark Puder
BACKGROUND: Fish oil lipid emulsion (FOLE) and multidisciplinary care for infants with intestinal failure (IF) have been associated with reduced morbidity and mortality due to IF-associated liver disease (IFALD). With increased survival, a greater proportion of infants with IF are now able to remain on parenteral nutrition (PN) in the long term. The purpose of this study was to examine outcomes in children with IFALD who have required long-term PN and FOLE therapy due to chronic IF. MATERIALS AND METHODS: A review of prospectively collected data was performed for children with IFALD who required at least 3 years of PN and FOLE therapy due to chronic IF...
March 9, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Prathima Nandivada, Gillian L Fell, Kathleen M Gura, Mark Puder
Long-term parenteral nutrition (PN) carries the risk of progressive liver disease in infants with intestinal failure. Although PN-associated liver disease (PNALD) is multifactorial in etiology, components of soybean oil lipid emulsions have been implicated in the disease's pathogenesis. Historically, infants with PNALD who were unable to wean from PN to full enteral feeding developed cirrhosis and end-stage liver disease, which require liver transplantation to survive. Over the past 2 decades, novel strategies for the management of parenteral lipids have improved morbidity and mortality from PNALD in infants with intestinal failure...
February 2016: American Journal of Clinical Nutrition
Arieh Riskin, Corina Hartman, Raanan Shamir
Parenteral nutrition (PN) must be initiated as soon as possible after delivery in very low birth weight (VLBW) preterm infants in order to prevent postnatal growth failure and improve neurodevelopmental outcome. When administered early, high levels of parenteral amino acids (AA) are well tolerated and prevent negative nitrogen balance. Although proteins are the driving force for growth, protein synthesis is energy-demanding. Intravenous lipid emulsions (ILE) constitute a good energy source because of their high energy density and provide essential fatty acids (FA) along with their long-chain polyunsaturated fatty acid (LC-PUFA) derivatives necessary for central nervous system and retinal development...
May 2015: Israel Medical Association Journal: IMAJ
Essam Imseis, J Marc Rhoads
A recent study attempts to add to the body of evidence that is emerging regarding the fish oil parenteral lipid product Omegaven™. The authors have shown from explant livers of children on chronic parenteral nutrition with Omegaven™ that biochemical improvement in cholestasis does not always reflect improvement in liver histology. These findings support 2 small case series that were previously published. Despite improvement and resolution of hyperbilirubinemia in all six infants, five of six infants had persistent or progressive hepatic fibrosis, while only one infant had regression of fibrosis...
May 7, 2015: World Journal of Gastroenterology: WJG
Chiara Biagetti, Luca Vedovelli, Sara Savini, Manuela Simonato, Rita D'Ascenzo, Adriana Pompilio, Paola E Cogo, Virgilio P Carnielli
BACKGROUND & AIMS: Provision of long chain polyunsaturated fatty acids (LCP) both of the omega-3 and omega-6 families is recommended for preterm infants (PI). Fish oil (FO) contains omega-3 and omega-6 LCP and it is incorporated in the fat blend of the new generation lipid emulsions (LE). Omega-3 LCP have been shown to reduce the expression of genes involved in lipogenesis, which could be important for several organs development. The aim of this study was to ascertain if the use of intravenous FO has an effect on lipogenesis in PI...
April 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Hye Won Park, Na Mi Lee, Ji Hee Kim, Kyo Sun Kim, Soo-Nyung Kim
BACKGROUND: Growing evidence indicates that fish oil-containing lipid emulsions have a beneficial effect on parenteral nutrition-associated cholestasis (PNAC) in adults; however, data are limited in neonates regarding the effect of fish oil on PNAC. OBJECTIVE: We conducted a meta-analysis of studies that addressed the effect of fish oil-containing lipid emulsions on reversing and preventing PNAC. METHODS: We searched PubMed, the EMBASE database, and the Cochrane Library for this systematic review and meta-analysis...
February 2015: Journal of Nutrition
Justine M Turner, Catherine J Field, Sue Goruk, Pamela Wizzard, Bryan J Dicken, Aisha Bruce, Paul W Wales
BACKGROUND: Fish oil monotherapy has been an advance for treating intestinal failure-associated liver disease (IFALD). However, such patients are at risk of bleeding complications from liver disease and because fish oil can inhibit thrombosis. We have previously reported abnormal platelet function in neonatal piglets given fish oil monotherapy during parenteral nutrition (PN). The purpose of this study was to determine if abnormal fatty acid composition of the platelets could explain the prior observed antiplatelet effect...
May 2016: JPEN. Journal of Parenteral and Enteral Nutrition
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
Miryam Triana Junco, Natalia García Vázquez, Carlos Zozaya, Marta Ybarra Zabala, Steven Abrams, Abelardo García de Lorenzo, Miguel Sáenz de Pipaón Marcos
Prolonged parenteral nutrition (PN) leads to liver damage. Recent interest has focused on the lipid component of PN. A lipid emulsion based on w-3 fatty acids decrease conjugated bilirubin. A mixed lipid emulsion derived from soybean, coconut, olive, and fish oils reverses jaundice. Here we report the reversal of cholestasis and the improvement of enteral feeding tolerance in 1 infant with intestinal failure-associated liver disease. Treatment involved the substitution of a mixed lipid emulsion with one containing primarily omega-3 fatty acids during 37 days...
2015: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Sanghoon Lee, Hyo Jung Park, Jihye Yoon, Seul Hee Hong, Chae-Youn Oh, Suk-Koo Lee, Jeong-Meen Seo
Intestinal failure-associated liver disease (IFALD) is a serious complication of parenteral nutrition (PN). Studies have shown that the amount and content of intravenous lipid emulsions (LEs) used is closely related to the development of IFALD. We report 2 cases of IFALD reversed by switching from a combination lipid emulsion containing fish oil to fish oil monotherapy (Omegaven; Fresenius Kabi Austria Gmbh, Graz, Austria). Patients initially received PN containing SMOFlipid 20% (SMOF; Fresenius Kabi Austria Gmbh, Graz, Austria), 2...
March 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Corina Hartman, Raanan Shamir
Parenteral nutrition (PN) in term newborns and older infants is often required for nutritional support for temporary or permanent intestinal failure from any reason. Lipid emulsions (LEs) are an essential source of high-density energy, essential fatty acids, and fat-soluble vitamins. Depending on the fatty acid type, LEs may also have significant immunomodulatory effects. All LEs, starting with soybean oil-based LE and subsequently with medium-chain triglycerides-, olive oil- and fish oil-based LEs, have been investigated in newborns and infants...
2015: World Review of Nutrition and Dietetics
Hester Vlaardingerbroek, Johannes B van Goudoever
Postnatal growth failure is still one of the most commonly observed morbidities in preterm infants. Intolerance of enteral nutrition is a common problem in these infants and in neonates with surgical conditions. Therefore, adequate parenteral nutrition is crucial to support organ development, including that of the brain. Short-term studies on the early introduction of parenteral lipids have demonstrated that early lipid administration seems safe and well tolerated and prevents essential fatty acid deficiency...
2015: World Review of Nutrition and Dietetics
Sarah J Carlson, Prathima Nandivada, Melissa I Chang, Paul D Mitchell, Alison O'Loughlin, Eileen Cowan, Kathleen M Gura, Vania Nose, Bruce R Bistrian, Mark Puder
OBJECTIVE: Parenteral nutrition associated liver disease (PNALD) is a deadly complication of long term parenteral nutrition (PN) use in infants. Fish oil-based lipid emulsion has been shown in recent years to effectively treat PNALD. Alternative fat sources free of essential fatty acids have recently been investigated for health benefits related to decreased inflammatory response. We hypothesized that the addition of medium-chain triglycerides (MCT) to a purified fish oil-based diet would decrease the response to inflammatory challenge in mice, while allowing for sufficient growth and development...
February 2015: Metabolism: Clinical and Experimental
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