Department of Pediatrics, Division of Neonatology, NorthShore University HealthSystem, Pritzker School of Medicine, University of Chicago, Evanston, IL, USA.
Department of Pediatrics, Division of Neonatology, Weill Cornell Medicine, New York, NY, USA.
J Perinatol. 2023 Sep;43(9):1189-1193. doi: 10.1038/s41372-023-01637-0. Epub 2023 Apr 8.
Intravenous lipid emulsions (ILEs) are an essential component of parenteral nutrition for very preterm and very low birth weight infants (VLBWs). This article offers a perspective on advancements and controversies on ILE use in this population. ILEs prescribed after birth at a dose of 1.5-2 g/kg/day and advanced to 3 g/kg/day enhance growth. Growth appears to be similar for infants who receive an ILE composed of 100% soybean oil or a multi-oil ILE with 15% fish oil. 100% fish oil is the preferred ILE for the management of parenteral nutrition associated cholestasis and intestinal failure associated liver disease. Research is warranted to help determine how we can optimize ILEs to improve neurodevelopment and prematurity complications. Last, we lack a universal definition of hypertriglyceridemia (HTG) and consensus on triglyceride surveillance and HTG management. Investigation is required to determine the health impact of specific triglyceride ranges in very preterm infants and VLBWs.
静脉内脂肪乳剂（ILEs）是极早产儿和极低出生体重儿（VLBW）肠外营养的重要组成部分。本文提供了在该人群中使用 ILE 的进展和争议的观点。出生后以 1.5-2g/kg/天的剂量开处方并增加至 3g/kg/天的 ILE 可促进生长。对于接受 100%豆油组成的 ILE 或含有 15%鱼油的多油 ILE 的婴儿，生长情况似乎相似。100%鱼油是治疗肠外营养相关胆汁淤积和肠衰竭相关肝病的首选 ILE。需要研究来帮助确定如何优化 ILE 以改善神经发育和早产并发症。最后，我们缺乏高甘油三酯血症（HTG）的通用定义以及对甘油三酯监测和 HTG 管理的共识。需要进行调查以确定极早产儿和极低出生体重儿特定甘油三酯范围的健康影响。
