Safety and efficacy of a lipid emulsion containing a mixture of soybean oil, medium-chain triglycerides, olive oil, and fish oil: A randomised, double-blind clinical trial in premature infants requiring parenteral nutrition

Erika Tomsits, Margit Pataki, Andrea Tq̈lgyesi, Gyq̈rgy Fekete, Katalin Rischak, Lajos Szollár

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Abstract

Objectives: Safety, tolerability, and efficacy of a novel lipid emulsion containing a mixture of soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOFlipid 20%) with reduced n-6 fatty acids (FA), increased monounsaturated and n-3 FA, and enriched in vitamin E were evaluated in premature infants compared with a soybean oil-based emulsion. Patients and Methods: Sixty (30/30) premature neonates (age 3-7 days, gestational age ≤34 weeks, birth weights 1000-2500 g) received parenteral nutrition (PN) with either SMOFlipid 20% (study group) or a conventional lipid emulsion (Intralipid 20%, control group) for a minimum of 7 up to 14 days. Lipid supply started at 0.5 g · kg body weight1 day-1 on day 1 and increased stepwise (by 0.5 g) up to 2 g · kg body weight1 day -1 on days 4 to 14. Safety and efficacy parameters were assessed on days 0, 8, and 15 if PN was continued. Results: Adverse events, serum triglycerides, vital signs, local tolerance, and clinical laboratory did not show noticeable group differences, confirming the safety of study treatment. At study end, g-glutamyl transferasewas lower in the study versus the control group (107.8-81.7 vs 188.8-176.7 IU/L, P<0.05). The relative increase in body weight (day 8 vs baseline) was 5.0%±6.5% versus 5.1%-6.6% (study vs control, not significant). In the study group, an increase in n-3 FA in red blood cell phospholipids and n-3:n-6 FA ratio was observed. Plasma a-tocopherol (study vs control) was increased versus baseline on day 8 (26.35±10.03 vs 3.67±8.06mmol/L, P<0.05) and atstudy termination (26.97±18.32 vs 8.73±11.41mmol/L, P<0.05). Conclusions: Parenteral infusion of SMOFlipid was safe and well tolerated and showed a potential beneficial influence on cholestasis, n-3 FA, and vitamin E status in premature infants requiring PN.

Original languageEnglish
Pages (from-to)514-521
Number of pages8
JournalJournal of pediatric gastroenterology and nutrition
Volume51
Issue number4
DOIs
Publication statusPublished - Oct 1 2010

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Keywords

  • Fish oil
  • Lipids
  • Parenteral nutrition
  • Premature birth
  • Vitamin E

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

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