KMID : 1034120130050020067
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Journal of Clinical Nutrition 2013 Volume.5 No. 2 p.67 ~ p.75
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Effects of SMOFlipid on Prophylaxis of Cho-lestasis in Premature Very Low Birth Weight Infants
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Kim Moon-Jin
Bae Hye-Jung Cho Yoon-Sook Kim Kwi-Suk Kim Hyang-Suk Lee Hye-Sook Lee Ju-Young Kim Ee-Kyung Kim Han-Suk
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Abstract
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Purpose: Very low birth weight infants (VLBWI) are found to have a higher incidence of cholestasis due to long-term total parenteral nutrition (TPN). Although there have been some studies on relationships between omega-3 fatty acids and reduced incidence of cholestasis, the advan-tages that the fatty acids provide for premature infant dis-eases have not yet been fully understood. The aim of this study was to evaluate the advantages of SMOFlipid, a lip-id emulsion product that contains omega-3 over other lip-id emulsion products that do not.
Methods: The medical records of 182 newborn (127 boys and 55 girls) were reviewed retrospectively between April 2010 and August 2012. These infants were born with a birth weight of £¼1,500 g and administered either of lipid emulsions (Intra MCT 20% or SMOFlipid) from birth to a full-feeding condition at our neonatal intensive care unit. Cholestasis is defined as serum direct bilirubin (DB) £¾1.0 mg/dL when total bilirubin (TB) is £¼5 mg/dL or DB/TB ratio is £¾20% when TB £¾5 mg/dL.
Results: The incidence of cholestasis was found to be lower in the SMOFlipid group than in the medium-chain triglyceride/long chain triglyceride (MCT/LCT) group (7.3% [4/55] versus 18.9% [24/127], P=0.046). At the start of lip-id emulsion administration (day 0), the baseline bilirubin level showed no significant difference between the two groups. However, the maximum value of DB on days 7¡14 was lower in the SMOFlipid group than in the MCT/ LCT group (0.8 [0.3¡2.2] versus 1.1 [0.3¡2.8] mg/dL, P= 0.030). The DB/TB ratio was also lower in the SMOFlipid group than in the MCT/LCT group (10.2% [4.9%¡40.0%] versus 24.1% [5.1%¡62.5%], P=0.002).
Conclusion: This study concluded that SMOFlipid was effective in the prevention of cholestasis in VLBWI. There-fore, omega-3-containing lipid emulsion can be highly rec-ommended in premature babies, especially in VLBWI who require TPN support.
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KEYWORD
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Very low birth weight infant, Total parenteral nutrition, Cholestasis, Retinopathy of prematurity, Omega- 3 fatty acids
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