Oxygen saturation to fraction of inspired oxygen ratio in preterm infants on routine parenteral nutrition with conventional or fish oil containing lipid emulsions

Abstract Background Preterm infants received long-term parenteral nutrition (PN) due to gastrointestinal immaturity. Mixed lipid emulsions composed of soybean oil, medium chain triglycerides (MCTs), olive oil, and fish oil, which have a relatively low ω-6: ω-3 ratio, may decrease the incidence of PN-associated cholestasis by reducing oxidative stress and providing an anti-inflammatory effect.Methods The retrospective cohort study enrolled a total 399 very low birth weight (VLBW) premature infants between January 2009 and November 2017 at a single neonatal intensive care unit. Preterm infants received total parenteral nutrition with either mixed lipid emulsion (SMOFlipid, n = 195) or soybean oil-based lipid emulsion (Lipovenoes, n = 204) for at least seven days. We compared the outcomes of PN-associated cholestasis, co-morbidities and mortality.Results The incidence of PN-associated cholestasis was significantly lower in the SMOFlipid group than the Lipovenoes group (10.3% vs 20.1%, P = 0.006). The related clinical laboratory findings, including levels of γ- GT (P = 0.019), triglyceride (P < 0.001), and cholesterol (P = 0.023), were significantly lower in the SMOFlipid group. The duration to full feeding days shortened in the SMOFlipid group compared with the Lipovenoes group (25 ± 10.33 vs 33 ± 16.22, P < 0.001). Relevant complications, such as severe retinopathy of prematurity (ROP, 3.6% vs 14.3%, P < 0.001) and bronchopulmonary dysplasia (BPD, 36.9% vs 46.7%, P = 0.046) were also reduced in the SMOFlipid group versus the Lipovenoes group, but there was no significant effect on severe intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), or mortality in both groups.Conclusions In very premature infants, PN with fish oil-based lipid emulsions is associated with a lower incidence of PN-associated cholestasis compared with soybean oil-based lipid emulsions.

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Parenteral nutrition with fish oil-based lipid emulsion reduces the risk of cholestasis in preterm infants

Journal of International Medical Research ◽

10.1177/03000605211011805 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110118

Author(s):

Yi-Ling Wang ◽

Lih-Ju Chen ◽

Lon-Yen Tsao ◽

Hsiao-Neng Chen ◽

Cheng-Han Lee ◽

...

Keyword(s):

Parenteral Nutrition ◽

Fish Oil ◽

Soybean Oil ◽

Preterm Infants ◽

Premature Infants ◽

Neonatal Intensive Care ◽

Lipid Emulsion ◽

Very Low Birth Weight ◽

Lipid Emulsions

Objective Preterm infants receive long-term parenteral nutrition (PN) for gastrointestinal immaturity. This study aimed to determine if mixed lipid emulsions containing fish oil decrease the incidence of PN-associated cholestasis by reducing oxidative stress and providing an anti-inflammatory effect. Methods This retrospective cohort study enrolled 399 very low birth weight premature infants (gestational age ≤32 weeks) between January 2009 and November 2017 at a single neonatal intensive care unit. Preterm infants received total PN with either mixed lipid emulsion including fish oil (SMOFlipid®, n = 195) or soybean oil-based lipid emulsion (Lipovenoes®, n = 204) for at least 7 days. We compared the outcomes of PN-associated cholestasis, comorbidities, and mortality between the groups. Results The incidence of PN-associated cholestasis was significantly lower in the SMOFlipid group than in the Lipovenoes group. The duration to full feeding days was significantly shorter in the SMOFlipid group compared with the Lipovenoes group. Relevant complications, such as severe retinopathy of prematurity and bronchopulmonary dysplasia, were also significantly reduced in the SMOFlipid group compared with the Lipovenoes group. Conclusion In premature infants, PN with fish oil-based lipid emulsions is associated with a lower incidence of PN-associated cholestasis compared with soybean oil-based lipid emulsions.

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Oxygen saturation/fraction of inspired oxygen ratio is a simple predictor of noninvasive positive pressure ventilation failure in critically ill patients

Journal of Critical Care ◽

10.1016/j.jcrc.2010.08.015 ◽

2011 ◽

Vol 26 (5) ◽

pp. 510-516 ◽

Cited By ~ 5

Author(s):

Carol Spada ◽

Rikesh Gandhi ◽

Sanjay R. Patel ◽

Paul Nuccio ◽

Gerald L. Weinhouse ◽

...

Keyword(s):

Oxygen Saturation ◽

Critically Ill ◽

Critically Ill Patients ◽

Positive Pressure Ventilation ◽

Noninvasive Positive Pressure Ventilation ◽

Positive Pressure ◽

Ventilation Failure ◽

Fraction Of Inspired Oxygen ◽

Oxygen Ratio ◽

Inspired Oxygen

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Correlation of oxygen saturation as measured by pulse oximetry/fraction of inspired oxygen ratio with Pao2/fraction of inspired oxygen ratio in a heterogeneous sample of critically ill children

Journal of Critical Care ◽

10.1016/j.jcrc.2012.12.006 ◽

2013 ◽

Vol 28 (4) ◽

pp. 538.e1-538.e7 ◽

Cited By ~ 20

Author(s):

Carlos Lobete ◽

Alberto Medina ◽

Corsino Rey ◽

Juan Mayordomo-Colunga ◽

Andrés Concha ◽

...

Keyword(s):

Oxygen Saturation ◽

Pulse Oximetry ◽

Critically Ill ◽

Critically Ill Children ◽

Heterogeneous Sample ◽

Fraction Of Inspired Oxygen ◽

Oxygen Ratio ◽

Inspired Oxygen

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Is intravenous fish oil associated with the neurodevelopment of extremely low birth weight preterm infants on parenteral nutrition?

Clinical Nutrition ◽

10.1016/j.clnu.2021.02.036 ◽

2021 ◽

Author(s):

Chiara Biagetti ◽

Alessio Correani ◽

Rita D’Ascenzo ◽

Enrica Ferretti ◽

Cecilia Proietti ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Parenteral Nutrition ◽

Fish Oil ◽

Preterm Infants ◽

Extremely Low Birth Weight

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Influence of Fish Oil-Containing Lipid Emulsions on Parenteral Nutrition-Associated Liver Disease in Neonates

Journal of Clinical Nutrition ◽

10.15747/jcn.2017.9.1.21 ◽

2017 ◽

Vol 9 (1) ◽

pp. 21-29

Author(s):

Jeong-A Park ◽

Ji-Eun Park ◽

Min-Jae Jeong ◽

Jae-Song Kim ◽

Eun-Sun Son ◽

...

Keyword(s):

Liver Disease ◽

Parenteral Nutrition ◽

Fish Oil ◽

Lipid Emulsions

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Phytosterolaemia associated with parenteral nutrition administration in adult patients

British Journal Of Nutrition ◽

10.1017/s0007114520000574 ◽

2020 ◽

Vol 123 (12) ◽

pp. 1365-1372 ◽

Cited By ~ 1

Author(s):

Josep M. Llop-Talaveron ◽

Elisabet Leiva-Badosa ◽

Ana Novak ◽

Raúl Rigo-Bonnin ◽

Josep R. Ticó-Grau ◽

...

Keyword(s):

Parenteral Nutrition ◽

Fish Oil ◽

Total Cholesterol ◽

Great Variability ◽

Adult Patients ◽

Lipid Emulsions ◽

Patient Study ◽

Hospitalised Patients

AbstractVegetable lipid emulsions (LE) contain non-declared phytosterols (PS). We aimed to determine PS content depending on the brand and LE batch, and in adult hospitalised patients treated with parenteral nutrition (PN), to establish the association between plasma and administered PS. Part I was the LE study: totals and fractions of PS in three to four non-consecutive batches from six LE were analysed. Part II was the patient study: patients with at least 7 previous days of PN with 0·8 g/kg per d of an olive/soyabean (O/S) LE were randomised (day 0) 1:1 to O/S or 100 % fish oil (FO) at a dose of 0·4 g/kg per d for 7 d (day 7). Plasma PS, its fractions, total cholesterol on days 0 and 7, their clearance and their association with PS administered by LE were studied. In part I, LE study: differences were found in the total PS, their fractions and cholesterol among different LE brands and batches. Exclusive soyabean LE had the highest content of PS (422·36 (sd 130·46) μg/ml). In part II, patient study: nineteen patients were included. In the O/S group, PS levels were maintained (1·11 (sd 6·98) μg/ml) from day 0 to 7, while in the FO group, significant decreases were seen in total PS (−6·21 (sd 4·73) μg/ml) and their fractions, except for campesterol and stigmasterol. Plasma PS on day 7 were significantly associated with PS administered (R2 0·443). PS content in different LE brands had great variability. PS administered during PN resulted in accumulation and could be prevented with the exclusive administration of FO LE.

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Intravenous Lipid Emulsions to Deliver Bioactive Omega-3 Fatty Acids for Improved Patient Outcomes

Marine Drugs ◽

10.3390/md17050274 ◽

2019 ◽

Vol 17 (5) ◽

pp. 274 ◽

Cited By ~ 11

Author(s):

Philip C. Calder

Keyword(s):

Fatty Acids ◽

Parenteral Nutrition ◽

Fish Oil ◽

Hospital Stay ◽

Critically Ill ◽

Adult Patients ◽

Lipid Emulsions ◽

Omega 3 Fatty Acids ◽

Omega 3 ◽

Meta Analyses

Lipids used in intravenous nutrition support (i.e., parenteral nutrition) provide energy, building blocks, and essential fatty acids. These lipids are included as emulsions since they need to be soluble in an aqueous environment. Fish oil is a source of bioactive omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid). Lipid emulsions, including fish oil, have been used for parenteral nutrition for adult patients post-surgery (mainly gastrointestinal). This has been associated with alterations in biomarkers of inflammation and immune defense, and in some studies, a reduction in length of intensive care unit and hospital stay. These benefits, along with a reduction in infections, are emphasized through recent meta-analyses. Perioperative administration of fish oil may be superior to postoperative administration, but this requires further exploration. Parenteral fish oil has been used in critically ill adult patients. Here, the influence on inflammatory processes, immune function, and clinical endpoints is less clear. However, some studies found reduced inflammation, improved gas exchange, and shorter length of hospital stay in critically ill patients if they received fish oil. Meta-analyses do not present a consistent picture but are limited by the small number and size of studies. More and better trials are needed in patient groups in which parenteral nutrition is used and where fish oil, as a source of bioactive omega-3 fatty acids, may offer benefits.

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