Neonatal Intensive Care Unit, San Cecilio Clinical Hospital, Granada, Spain.
Medicine Faculty. Granada, Spain.
Am J Perinatol. 2021 Jul;38(9):952-959. doi: 10.1055/s-0039-1701026. Epub 2020 Jan 27.
Intralipid (Fresenius Kabi) was the most commonly used lipid emulsion in parenteral nutrition (PN), with a 100% soybean oil composition, a low vitamin E content, and a ω-6: ω-3 ratio of 7:1. A recent alternative formulation is SMOFlipid (Fresenius Kabi), with a ω-6: ω-3 ratio of 5:2 and higher vitamin E content. A retrospective observational study was conducted to determine neonatal morbidity in very low birth weight (VLBW) premature infants during two periods: P1, when PN was based exclusively on Intralipid, and P2, when only SMOFlipid was supplied. In total, 170 VLBW neonates were analyzed, of whom 103 received PN for more than 6 days, 56 during P1, and 47 during P2. In both periods, the antenatal and neonatal characteristics of the cohort were comparable. In this analysis, the prevalence of associated comorbidities was determined. During P2, there were fewer cases of moderate to severe bronchopulmonary dysplasia (BPD) and of cholestasis, but more cases of late sepsis, mainly . No changes in the prevalence of other neonatal comorbidities were observed. We believe that the SMOFlipid used in PN could discreetly improve the prevalence of cholestasis or BPD.
力文（费森尤斯卡比）是肠外营养（PN）中最常用的脂肪乳剂，其成分为 100%的大豆油，维生素 E 含量低，ω-6：ω-3 的比例为 7：1。最近有一种替代配方是 SMOLipid（费森尤斯卡比），其 ω-6：ω-3 的比例为 5：2，维生素 E 含量更高。一项回顾性观察研究旨在确定极低出生体重（VLBW）早产儿在两个时期的新生儿发病率：P1 期，PN 完全基于力文，P2 期，仅供应 SMOLipid。共有 170 例 VLBW 新生儿接受了分析，其中 103 例 PN 治疗超过 6 天，56 例在 P1 期，47 例在 P2 期。在两个时期，队列的产前和新生儿特征均具有可比性。在本分析中，确定了相关合并症的患病率。在 P2 期，中重度支气管肺发育不良（BPD）和胆汁淤积的病例较少，但晚期败血症的病例较多，主要是由凝固酶阴性葡萄球菌引起的。未观察到其他新生儿合并症患病率的变化。我们认为，PN 中使用的 SMOLipid 可能会轻微改善胆汁淤积或 BPD 的患病率。
