Safflower oil emulsion administration during parenteral nutrition in the preterm infant. 1. Effect on essential fatty acid status.

To determine the effect of a safflower oil emulsion on the essential fatty acid (EFA) status of preterm infants during parenteral nutrition, subjects were randomized to receive Liposyn at 0.34 g (group 1), 0.68 g (less than 0.5% of lipid from linolenic acid, group 2), or Modified Liposyn at 0.68 g/kg/day (5.0% of lipid from linolenic acid, group 3). Doses of 0.34 and 0.68 g of Liposyn provided linoleic acid in amounts equivalent to 2 and 4% of the estimated caloric requirement (120 cal/kg/day) and 5 and 10% of the actual caloric intake. No significant differences were detected in plasma phospholipid triene/tetraene ratios and arachidonic acid levels between groups 1 and 2 or between groups 2 and 3, respectively. Plasma phospholipid triene/tetraene ratio and arachidonic acid did not change in the lipid-supplemented group throughout the study period, but the former remained significantly lower (p less than 0.001) and the latter significantly greater (p less than 0.001) than in a reference group of infants who received fat-free parenteral nutrition. We conclude that Liposyn administration providing linoleic acid at 2 or 4% of the estimated caloric requirement or 5 or 10% of the actual caloric intake prevented any significant changes in essential fatty acid status from occurring. Moreover, linolenic acid supplementation at 5% of the total lipid intake did not appear to affect arachidonic acid synthesis in the preterm infant.