Research Institute, University of Toronto, Toronto, Canada.
Group for Improvement of Intestinal Function and Treatment (GIFT), University of Toronto, Toronto, Canada.
JPEN J Parenter Enteral Nutr. 2020 May;44(4):688-696. doi: 10.1002/jpen.1692. Epub 2019 Aug 25.
SMOFlipid has a more diverse lipid profile than traditional Intralipid and has become the standard lipid for patients in our intestinal rehabilitation program. Our objective was to compare outcomes in neonates with intestinal failure (IF) who received SMOFlipid against those receiving Intralipid.
This was a retrospective cohort study of infants with IF with a minimum follow-up of 12 months in 2008-2016. Patients were stratified into 2 groups: group 1 received SMOFlipid; group 2 was a historical cohort who received Intralipid. The primary outcome was liver function evaluated using conjugated bilirubin (CB) levels. Statistical analysis included the Mann-Whitney U and χ tests, with an α value < 0.05 considered significant. Approval was obtained from our institutional review board.
Thirty-seven patients were evaluated (17 = SMOFlipid, 20 = Intralipid). SMOFlipid patients were less likely to reach CB of 34 (24% vs 55%, P = 0.05), 50 µmol/L (11.8% vs 45%; P = 0.028), and did not require Omegaven (0% vs 30%; P = 0.014). CB level at 3 months after initiation of parenteral nutrition (PN) was lower in patients receiving SMOFlipid (0 vs 36 µmol/L; P = 0.01). Weight z-scores were improved for patients receiving SMOFlipid at 3 months (-0.932 vs -2.092; P = 0.028) and 6 months (-0.633 vs -1.614; P = 0.018). There were no differences in PN-supported patients or demographics between the groups.
Use of SMOFlipid resulted in decreased development of IF-associated liver disease in patients with IF when assessed using biochemical tests.
SMOFlipid 的脂质谱比传统的 Intralipid 更为多样化，已成为我们肠道康复计划中患者的标准脂质。我们的目的是比较接受 SMOFlipid 和 Intralipid 的肠衰竭（IF）新生儿的结局。
这是一项回顾性队列研究，纳入了 2008 年至 2016 年期间至少随访 12 个月的 IF 婴儿。患者分为 2 组：组 1 接受 SMOFlipid；组 2 为接受 Intralipid 的历史队列。主要结局是使用结合胆红素（CB）水平评估肝功能。统计分析包括 Mann-Whitney U 和 χ 检验，α 值 < 0.05 认为有统计学意义。本研究获得了机构审查委员会的批准。
共评估了 37 例患者（17 例=SMOFlipid，20 例=Intralipid）。SMOFlipid 患者更不可能达到 CB 34（24%比 55%，P=0.05）、50μmol/L（11.8%比 45%，P=0.028），且不需要使用 Omegaven（0%比 30%，P=0.014）。接受 SMOFlipid 的患者在开始肠外营养（PN）后 3 个月时 CB 水平较低（0 比 36μmol/L；P=0.01）。接受 SMOFlipid 的患者在 3 个月（-0.932 比-2.092；P=0.028）和 6 个月（-0.633 比-1.614；P=0.018）时体重 z 评分改善。两组患者的 PN 支持率和人口统计学特征无差异。
在使用生化检测评估 IF 患者时，使用 SMOFlipid 可降低 IF 相关肝病的发生。
