Ozkan Hilal, Koksal Nilgun, Dorum Bayram Ali, Kocael Fatma, Ozarda Yesim, Bozyigit Cengiz, Dogan Pelin, Guney Varal Ipek, Bagci Onur
Division of Neonatology, Department of Pediatrics, Uludag University Medical Faculty, Bursa, Turkey.
Department of Medical Biochemistry, Uludag University Medical Faculty, Bursa, Turkey.
Pediatr Int. 2019 Apr;61(4):388-392. doi: 10.1111/ped.13798.
Parenteral nutrition (PN) has been widely used in preterm infants. The lipid solutions used for PN, however, are associated with oxidative stress and morbidity. The aim of this study was to compare the effectiveness of a new-generation lipid emulsion (SMOFLipid) and olive-oil based lipid emulsion for prevention of PN-associated oxidative damage.
Preterm infants < 32 weeks of gestational age were included in this prospective randomized study. All infants were randomized to SMOFlipid or olive-oil based lipid emulsion (ClinOleic). Lipid peroxidation products were evaluated in all infants. In addition, total antioxidant capacity (TAC), and both pro- and anti-inflammatory cytokines were studied at days 0, 7 and 14.
A total of 89 infants (SMOFlipid, n = 42; ClinOleic, n = 47) were enrolled. TAC was higher in the SMOFlipid group compared with the ClinOleic group at all time points, and the difference on day 7 was statistically significant. Although the anti-inflammatory cytokine interleukin-10 was higher in the SMOFlipid group, this difference was not significant. Bronchopulmonary dysplasia (BPD) was lower in the SMOFlipid group (14.1%) than in the ClinOleic group (31.2%), but this finding was non-significant p > 0.05. The rate of severe BPD was significantly lower in the SMOFlipid group.
To our best of knowledge, this is the first study to suggest that SMOFlipid might decrease oxidative damage and oxidative-stress-associated morbidity compared with olive oil-based emulsion in preterm infants.
肠外营养（PN）已广泛应用于早产儿。然而，用于PN的脂质溶液与氧化应激和发病率相关。本研究的目的是比较新一代脂质乳剂（SMOFlipid）和橄榄油基脂质乳剂预防PN相关氧化损伤的效果。
本前瞻性随机研究纳入了胎龄<32周的早产儿。所有婴儿被随机分为SMOFlipid组或橄榄油基脂质乳剂（ClinOleic）组。对所有婴儿评估脂质过氧化产物。此外，在第0、7和14天研究总抗氧化能力（TAC）以及促炎和抗炎细胞因子。
共纳入89例婴儿（SMOFlipid组，n = 42；ClinOleic组，n = 47）。在所有时间点，SMOFlipid组的TAC均高于ClinOleic组，且第7天的差异具有统计学意义。虽然SMOFlipid组的抗炎细胞因子白细胞介素-10较高，但差异不显著。SMOFlipid组的支气管肺发育不良（BPD）发生率（14.1%）低于ClinOleic组（31.2%），但这一发现无统计学意义（p>0.05）。SMOFlipid组的重度BPD发生率显著较低。
据我们所知，这是第一项表明与橄榄油基乳剂相比，SMOFlipid可能降低早产儿氧化损伤和氧化应激相关发病率的研究。
