EXPRESS: Does the use of fish-oil based lipid emulsion in the clinical setting of total parenteral nutrition (TPN) and lipid rescue therapy interfere with common laboratory analytes on Roche Cobas 6000?

2020 ◽  
pp. 000456322098659
Author(s):  
Jun Guan Tan ◽  
Moh Sim Wong
Keyword(s):  
Parenteral Nutrition ◽  
Fish Oil ◽  
Total Parenteral Nutrition ◽  
Clinical Setting ◽  
High Speed ◽  
Lipid Emulsion ◽  
Rescue Therapy ◽  
Lipid Rescue ◽  
State Concentration ◽  
Roche Cobas

Background Lipaemic interference on automated analysers has been widely studied using soy-based emulsion such as Intralipid. Due to the greater adoption of fish oil-based lipid emulsion for total parenteral nutrition in view of improved clinical outcomes, we seek to characterize the optical properties of SMOFLipid 20%(Fresenius Kabi, Bad Homburg, Germany), a fish-oil based emulsion, on the Roche Cobas 6000 chemistry analyser(Roche Diagnostic, Basel, Switzerland). Method Various amounts of SMOFlipid were spiked into pooled seras. We plotted Roche Cobas Serum Indices Lipaemic indices(L-index) against the amount of SMOFlipid added. We then studied the interference thresholds for AST, ALT, Albumin and renal panel analytes using SMOFlipid. We subjected five levels of spiked lipaemia to high speed centrifugation and analysed the specimens pre and post centrifugation. To postulate whether fish-oil based lipid emulsion interferes with laboratory results in the clinical setting, we calculated concentrations of SMOFlipid post lipid rescue therapy and steady state concentration of a typical TPN regime using pharmacokinetic principles. Results SMOFlipid optical behaviour is similar to Intralipid using the Serum indices L-index, with 1mg/dL of SMOFlipid representing 1 unit of L-index. Manufacturer stated interference thresholds are accurate for ALT, AST, albumin, urea and creatinine. High speed centrifugation at 60 min 21100G facilitates the removal of fish-oil based SMOFlipid. Conclusion Based on the interference thresholds we verified and pharmacokinetics parameters provided by SMOFlipid manufacturer, total parenteral nutrition may not interfere with chemistry analytes given sufficient clearance, but lipid rescue therapy will interfere. Further studies assessing lipaemic interference on immunoassays are needed

scholarly journals Fish Oil Lipid Emulsion-Associated Sea-Blue Histiocyte Syndrome in a Pediatric Patient

2015 ◽  
Vol 20 (3) ◽  
pp. 217-221
Author(s):  
Ting Ting Wu ◽  
David S. Hoff
Keyword(s):  
Bone Marrow ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Soybean Oil ◽  
Total Parenteral Nutrition ◽  
Pediatric Patient ◽  
Lipid Emulsion

A syndrome of hepatosplenomegaly, thrombocytopenia, and anemia and the presence of sea-blue histiocytes in bone marrow has been associated with parenteral soybean oil administration in patients receiving long-term total parenteral nutrition (TPN). A case is described here where this syndrome was observed in a pediatric patient who received long-term parenteral fish oil nutrition.

Intravenous lipid composition affects hypoxic pulmonary vasoconstriction in the newborn piglet

2001 ◽  
Vol 79 (7) ◽  
pp. 594-600 ◽  
Author(s):  
Keith J Barrington ◽  
George Chan ◽  
John E. Van Aerde
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Output ◽  
Fatty Acid ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Total Parenteral Nutrition ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Plasma Levels ◽  
Lipid Emulsion

To examine the effects of altering the fatty acid (FA) composition of intravenous (IV) lipid emulsions on pulmonary vascular resistance (PVR) and thromboxane production, we studied three groups of newborn piglets after three days of either sow's milk (milk), or total parenteral nutrition (TPN) with either iv soy bean oil (SBO, 52% n-6 and 8% n-3 FA) or fish oil (FO, 5% n-6 and 51% n-3 FA) emulsions. At baseline, and during hypoxia at 20 min and 2 h, cardiac output (Q) was measured, PVR calculated and plasma levels of a prostacyclin metabolite (6-keto-PgF1α) and thromboxane B2 (TxB2) were measured. Fatty acid composition of the lung phospholipids was analyzed. There was an exaggerated increase in PVR and decrease in Q during prolonged hypoxia in the TPN-SBO group as compared with the other two groups. There was no difference in PVR and Q between the milk and TPN-FO groups. FA of lung phospholipids reflected the high dietary level of long chain n-3 FA in the TPN-FO group. However, no differences in plasma levels of 6-keto-PgF1α or TxB2 were found. Intravenous emulsions made from SBO reduced cardiac output and increased pulmonary vascular resistance in the hypoxic newborn piglet, whereas iv FO emulsions did not. When subjects with pulmonary hypertension are receiving TPN iv SBO may be detrimental; iv FO may be beneficial, giving similar responses as in a milk-fed subject.Key words: total parenteral nutrition, fish oil, pulmonary hypertension, lipid emulsion, fatty acids.Key words: total parenteral nutrition, fish oil, pulmonary hypertension, lipid emulsion, fatty acids.

scholarly journals Parenteral fish-oil-based lipid emulsion improves fatty acid profiles and lipids in parenteral nutrition-dependent children

2011 ◽  
Vol 94 (3) ◽  
pp. 749-758 ◽  
Author(s):  
H. D. Le ◽  
V. E. de Meijer ◽  
E. M. Robinson ◽  
D. Zurakowski ◽  
A. K. Potemkin ◽  
...  
Keyword(s):  
Fatty Acid ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Lipid Emulsion ◽  
Fatty Acid Profiles ◽  
Dependent Children

scholarly journals A Retrospective Analysis of the Effect of Combination of Pure Fish Oil with Third Generation Lipid Emulsion on Liver Function in Children on Long-Term Parenteral Nutrition

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2495
Author(s):  
Mikołaj Danko ◽  
Aleksandra Żyła-Pawlak ◽  
Janusz Książyk ◽  
Katarzyna Olszewska-Durkacz ◽  
Marta Sibilska ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Retrospective Analysis ◽  
Lipid Emulsion ◽  
Intestinal Failure ◽  
Third Generation ◽  
Glutamyl Transferase

Background: Deterioration of liver function, or intestinal failure-associated liver disease, is often observed in long-term parenterally fed children. Fish oil-based intravenous lipids have been reported to play a role in the prevention and treatment of intestinal failure associated liver disease. Methods: This retrospective analysis included 40 pediatric patients, (20 male and 20 female), median age 38 months (range 1.5–200 months) on long-term (≥1 month) parenteral nutrition who received the parenteral mixtures containing a combination of a third-generation lipid emulsion and pure fish oil because of laboratory liver function abnormalities. The total dose of fish oil from both emulsions for each patient exceeded 0.5 g/kg/day. Data from visits in an outpatient clinic were retrospectively analyzed using the Wilcoxon test, Mann-Whitney test, and Spearman correlation test. Results: The median time of therapy was 149 days (range 28–418 days). There was a decrease of median total and direct (conjugated) bilirubin concentration from 22.23 µmol/L (range 3.42–243 µmol/L) to 10.26 µmol/L (range 3.42–180.58 µmol/L; p < 0.005) and 8.55 (range 1.71–212.04 µmol/L) to 6.84 µmol/L (range 1.71–150.48 µmol/L; p < 0.007) respectively. A significant decrease in median alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase was also observed. In 11 patients bilirubin concentrations increased or remained unchanged. When compared to the patients who responded to the combination therapy, the patients who did not respond received parenteral nutrition for a longer time prior to the start of the therapy (51 vs. 30 months; p < 0.05). Conclusions: The mixture of an intravenous lipid emulsion containing soybean oil, medium-chain triglycerides, olive oil, and fish oil with the addition of pure fish oil emulsion may be helpful in the treatment of liver complications in children on long-term parenteral nutrition.

Double blind exploratory study on de novo lipogenesis in preterm infants on parenteral nutrition with a lipid emulsion containing 10% fish oil

2016 ◽  
Vol 35 (2) ◽  
pp. 337-343 ◽  
Author(s):  
Chiara Biagetti ◽  
Luca Vedovelli ◽  
Sara Savini ◽  
Manuela Simonato ◽  
Rita D'Ascenzo ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Fish Oil ◽  
Preterm Infants ◽  
Exploratory Study ◽  
Lipid Emulsion ◽  
De Novo ◽  
De Novo Lipogenesis ◽  
Double Blind
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