Drs. Cashore and Usher Reply

We are indeed interested to learn that Higgs et al.1 have achieved early growth rates comparable to those in our study with the use of intravenous fat emulsion in small premature infants. Further information on the metabolic complications and autopsy findings encountered in their study would provide important additional evidence concerning the effectiveness and potential hazards of using intravenous fat emulsions in sick newborns. There was a difference between the two studies in the method of infusing the fat emulsion.

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Microbial Growth in Neonatal Intravenous Fat Emulsion Administered Over 12 Versus 24 Hours

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-18.4.298 ◽

2013 ◽

Vol 18 (4) ◽

pp. 298-302 ◽

Cited By ~ 1

Author(s):

Bethany M. DeDonato ◽

Lisa I. Bickford ◽

Ryan J. Gates

Keyword(s):

Neonatal Intensive Care ◽

Microbial Growth ◽

Medical Center ◽

Infusion Time ◽

Fat Emulsion ◽

Intravenous Fat Emulsion ◽

Fat Emulsions ◽

Infusion Method ◽

Extended Infusion ◽

Intravenous Fat Emulsions

OBJECTIVES To determine whether an extended infusion time (24 hours) of intravenous fat emulsion is associated with an increase in microbial growth, versus a shorter infusion time (12 hours). METHODS Samples were collected from intravenous fat emulsions (n=132), from intravenous fat emulsions prepared in the current 24-hour infusion method (n=55), and from intravenous fat emulsions prepared in the twice-daily (12-hour infusion) method (n=55). In addition, samples were collected from pharmacy (n=22) to test for possible contamination. RESULTS No growth was observed in either arm of the study. CONCLUSIONS Current Kern Medical Center policy of preparation and administration of neonatal intensive care unit intravenous fat emulsion is safe and effective in regard to microbial growth.

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Effect of heparin dose and infusion rate on lipid clearance and bilirubin binding in premature infants receiving intravenous fat emulsions

The Journal of Pediatrics ◽

10.1016/s0022-3476(88)80129-x ◽

1988 ◽

Vol 112 (1) ◽

pp. 94-98 ◽

Cited By ~ 29

Author(s):

M.L. Spear ◽

G.E. Stahl ◽

M. Hamosh ◽

W.G. McNelis ◽

L.L. Richardson ◽

...

Keyword(s):

Premature Infants ◽

Infusion Rate ◽

Heparin Dose ◽

Fat Emulsions ◽

Bilirubin Binding ◽

Intravenous Fat Emulsions

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Faculty Opinions recommendation of Increased early growth rates decrease longevities of conifers in subalpine forests.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14204957.15721057 ◽

2012 ◽

Author(s):

Christian Körner

Keyword(s):

Growth Rates ◽

Early Growth ◽

Subalpine Forests

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The Winter Flounder (Pseudopleuronectes americanus) in Long Pond, Conception Bay, Newfoundland

Journal of the Fisheries Research Board of Canada ◽

10.1139/f71-170 ◽

1971 ◽

Vol 28 (8) ◽

pp. 1153-1165 ◽

Cited By ~ 28

Author(s):

V. S. Kennedy ◽

D. H. Steele

Keyword(s):

Food Intake ◽

Growth Rates ◽

Plant Material ◽

Early Growth ◽

Winter Flounder ◽

Pseudopleuronectes Americanus ◽

Food Items ◽

Fish Remains ◽

Males And Females ◽

Conception Bay

Monthly samples of winter flounder taken in Long Pond from November 1962 to October 1963 indicated that the flounder moved into deeper water (7–10 m) during the summer and returned to shallow water (1–2 m) from September to June. These movements corresponded to the end of the spawning season and the ripening of the gonads respectively. Spawning occurred from March until early June, most of it in May and early June. Most males were mature at age 6 and most females at age 7. Fifty percent of the males and females were mature at 21 and 25 cm respectively. The growth rates of the males and females were similar until the age of 8, after which the females apparently outgrew the males. Early growth and fecundity were similar to those reported for other areas. No feeding took place in December or January but the flounder fed in March and continued to feed throughout the summer; food intake decreased in the fall. They were omnivorous and the type of food eaten varied with the locality. Polychaetes, plant material, and molluscs were the most common food items throughout the year. Capelin eggs and fish remains were found only during a few months of the year but were eaten in great quantities.

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State of the Art Review: Intravenous Fat Emulsions: Current Applications, Safety Profile, and Clinical Implications

Annals of Pharmacotherapy ◽

10.1345/aph.1m626 ◽

2010 ◽

Vol 44 (4) ◽

pp. 688-700 ◽

Cited By ~ 90

Author(s):

Jay M Mirtallo ◽

Joseph F Dasta ◽

Kurt C Kleinschmidt ◽

Joseph Varon

Keyword(s):

Safety Profile ◽

State Of The Art ◽

Clinical Implications ◽

Fat Emulsions ◽

Intravenous Fat Emulsions

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Use of Intravenous Fat Emulsions in Surgical Patients

Surgical Clinics of North America ◽

10.1016/s0039-6109(16)35691-2 ◽

1959 ◽

Vol 39 (1) ◽

pp. 145-159 ◽

Cited By ~ 5

Author(s):

Frederick W. Preston ◽

George C. Henegar

Keyword(s):

Surgical Patients ◽

Fat Emulsions ◽

Intravenous Fat Emulsions

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A Randomized Trial of Micropreemies Receiving Higher Amounts of Intravenous Fat Emulsion During the First Week of Life

ICAN Infant Child & Adolescent Nutrition ◽

10.1177/1941406411429847 ◽

2011 ◽

Vol 4 (1) ◽

pp. 58-66

Author(s):

Douglas Drenckpohl ◽

Matthew Niehaus ◽

Catherine Schneider ◽

Connie McConnell ◽

Huaping Wang ◽

...

Keyword(s):

Randomized Trial ◽

Fat Emulsion ◽

Intravenous Fat Emulsion

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Intravenous Alimentation and Insensible Water Loss in Low-Birth- Weight Infants

PEDIATRICS ◽

10.1542/peds.63.4.543 ◽

1979 ◽

Vol 63 (4) ◽

pp. 543-546

Author(s):

Keith H. Marks ◽

Timothy P. Farrell ◽

Zvi Friedman ◽

M. Jeffrey Maisels

Keyword(s):

Amino Acid ◽

Acid Solution ◽

Water Loss ◽

Caloric Intake ◽

Constant Infusion ◽

Fat Emulsion ◽

Low Birth Weight Infants ◽

Amino Acid Solution ◽

Intravenous Fat Emulsion ◽

Multiple Measurements

Insensible water loss (IWL) was measured in six premature infants, betWeen 4 and 21 days of age, by continuous weight monitoring on an electronic balance inside an incubator. Multiple measurements of IWL were made during the sequential infusion of 10% dextrose in 0.225% NaCl, 10% dextrose-amino acid solution, or 10% dextrose-amino acid and a commercial intravenous fat emulsion. Each solution was administered for three hours by constant infusion through a scalp vein needle. The order of the infusion was random and a 30-to 60-minute infusion with 5% dextrose water was given between each solution. During the infusion of 10% dextrose in 0.225% NaCl and 10% dextrose + amino acid solution, IWL was 1.0 ± 0.8 gm/kg/ hr and 1.1 ± 0.8 gm/kg/hr, respectively. In contrast, IWL increased significantly to 1.6 ± 0.7 gni/kg/hr when additional calories were given using the 10% dextrose-amino acid with the intravenous fat emulsion (P < .005). There was a positive correlation between caloric intake and IWL. These data suggest that parenteral nutrition solutions with intravenous fat emulsion are rapidly metabolized and the increase in IWL is probably secondary to an increase in thermogenesis.

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