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

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.

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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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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

Gastroenterology Research and Practice ◽

10.1155/2016/4139164 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Leilei Wang ◽

Jing Zhang ◽

Jiejin Gao ◽

Yan Qian ◽

Ya Ling

Keyword(s):

Birth Weight ◽

Parenteral Nutrition ◽

Fish Oil ◽

Soybean Oil ◽

Premature Infants ◽

Lipid Emulsion ◽

Lipid Emulsions ◽

Feeding Intolerance ◽

Total Dosage

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. Analysis was made on the gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, age at which feeding began, usage of lipid emulsions, and incidence of cholestasis between the two groups.Results. There were no statistical differences in terms of gender, feeding intolerance, infection history, birth weight, gestational age, duration of parenteral nutrition, total dosage of amino acid, and age at which feeding began. Besides, total incidence of cholestasis was 21.3%, and the days of life of occurrence of cholestasis were53±5.0days. Incidence of cholestasis had no statistical difference in the two groups.Conclusion. This study did not find the different role of fish oil-based lipid emulsions and soybean oil-based lipid emulsions in cholestasis associated with long-term parenteral nutrition in premature infants.

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How to perform appropriate flushing after lipid emulsion administration using totally implantable venous access devices in long-term total parenteral nutrition and home parenteral nutrition

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2020.11.019 ◽

2020 ◽

Author(s):

Naoya Okamura ◽

Takae Yamato ◽

Ippei Yamaoka ◽

Kazuhisa Doi ◽

Yu Koyama

Keyword(s):

Parenteral Nutrition ◽

Total Parenteral Nutrition ◽

Lipid Emulsion ◽

Venous Access ◽

Home Parenteral Nutrition ◽

Venous Access Devices

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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

Yearbook of Surgery ◽

10.1016/j.ysur.2011.04.119 ◽

2011 ◽

Vol 2011 ◽

pp. 181-182

Author(s):

J.M. Daly

Keyword(s):

Clinical Trial ◽

Parenteral Nutrition ◽

Fish Oil ◽

Soybean Oil ◽

Premature Infants ◽

Lipid Emulsion ◽

Medium Chain Triglycerides ◽

Double Blind ◽

Safety And Efficacy ◽

Double Blind Clinical Trial

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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 ◽

10.3390/nu11102495 ◽

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.

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