Department of Physiology, Faculty of Medicine, C/Arzobispo Morcillo 2, Universidad Autónoma de Madrid, 28029 Madrid, Spain.
Department of Neonatology, Instituto de Investigación Sanitaria Hospital Universitario La Paz (IdiPAZ), Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain.
Nutrients. 2023 Jan 18;15(3):509. doi: 10.3390/nu15030509.
Resolution of parenteral nutrition-associated liver disease has been identified in infants receiving SMOFlipid™ or a 100% fish oil lipid emulsion (FOLE). However, the effect of FOLE is unknown when the previous emulsion received is a mixed lipid emulsion containing fish oil. This observational pilot study reports data regarding the use of Omegaven™ after the diagnosis of cholestasis while receiving SMOFlipid™. We conducted a retrospective review of medical charts of neonates in which a partially fish oil-based lipid emulsion was replaced by a fish oil lipid emulsion at 1 g/kg/day due to cholestasis. Thirty-eight infants (92.1% preterm, being 44.7% born below 28 weeks' gestation), received FOLE. Birth weight was 1390 (743.0; 2298) grams. The age that cholestasis diagnosed was 15.0 (10.0; 24.8) days. The fish oil emulsion was administered for 38.5 (11.2; 51.8) days. In 73.7% (28/38) of the neonates, the cholestasis was resolved. In 34.2% (13/38), resolution happened before FOLE discontinuation. In addition, in the rest of the neonates (15) in whom cholestasis resolved, resolution occurred after FOLE discontinuation. Nine of the neonates died. In conclusion, the use of a 100% fish oil-based emulsion in neonates afflicted with cholestasis developed while on a partially fish oil-based emulsion is associated with a bilirubin decrease.
肠外营养相关性肝病在接受 SMOFlipidTM 或 100%鱼油脂肪乳（FOLE）的婴儿中已得到解决。然而，当之前使用的乳剂是含有鱼油的混合脂肪乳剂时，FOLE 的效果尚不清楚。本观察性试点研究报告了在接受 SMOFlipidTM 时诊断为胆汁淤积后使用 OmegavenTM 的相关数据。我们对因胆汁淤积而将部分含鱼油的脂肪乳剂更换为 1g/kg/天的鱼油脂肪乳剂的新生儿的病历进行了回顾性审查。38 名婴儿（92.1%早产儿，44.7%出生于 28 周以下）接受了 FOLE。出生体重为 1390（743.0；2298）克。诊断为胆汁淤积的年龄为 15.0（10.0；24.8）天。鱼油乳剂的使用时间为 38.5（11.2；51.8）天。在 73.7%（28/38）的新生儿中，胆汁淤积得到解决。在 34.2%（13/38）的新生儿中，在 FOLE 停药前，胆汁淤积得到解决。此外，在其余 15 名（15 名）胆汁淤积得到解决的新生儿中，在 FOLE 停药后，胆汁淤积得到解决。9 名新生儿死亡。总之，在接受部分含鱼油的脂肪乳剂治疗的同时患有胆汁淤积的新生儿中使用 100%鱼油基乳剂与胆红素降低有关。
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