Long-term Exposure of Children to a Mixed Lipid Emulsion Is Less Hepatotoxic Than Soybean-based Lipid Emulsion. Issue 3 (March 2018)

• Record Type: Journal Article
• Authors: Lam, Carol K.L.; Church, Peter C.; Haliburton, Beth; Chambers, Kathryn; Martincevic, Inez; Vresk, Laura; Courtney-Martin, Glenda; Bandsma, Robert; Avitzur, Yaron; Wales, Paul C.; Mouzaki, Marialena
• Is Part Of: Journal of pediatric gastroenterology and nutrition. Volume 66:Issue 3(2018)
• Publication Date: 2018-03
• Subjects: hepatotoxicity -- Intralipid -- long-term exposure -- parenteral nutrition -- pediatrics -- SMOFLipid; Children -- Nutrition -- Periodicals; Pediatric gastroenterology -- Periodicals; Infants -- Nutrition -- Periodicals; Nutrition disorders in children -- Periodicals; Child Nutrition -- Periodicals; Digestive System -- growth & development -- Periodicals; Gastrointestinal Diseases -- Periodicals; Infant Nutrition -- Periodicals; Nutrition Disorders -- Periodicals; Child; 618.923
• DOI: 10.1097/MPG.0000000000001799
• Languages: English
• ISSNs: 0277-2116

Abstract

Abstract : ABSTRACT: Lipid emulsions have been associated with liver injury. Newer mixed emulsions (ML), such as SMOFlipid (Fresenius Kabi, Germany), are thought to be more hepatoprotective than soybean-based emulsions (SL), such as Intralipid (Baxter). Pediatric studies comparing long-term use between the 2 are limited. This study compares the severity of hepatic injury between a prospective cohort of hospitalized children on ML (n = 20) and a historical age- and diagnosis-matched cohort of hospitalized children on SL (n = 20). Median exposure to ML and SL were 10 versus 6 weeks ( P = 0.030), respectively, at similar median lipid doses (2.2 vs 2.1 g · kg −1 · day −1 ). Using a generalized estimating equations approach, conjugated bilirubin trajectory was found to be lower in patients on ML compared with SL ( P < 0.001), suggesting that prolonged exposure (≥4 weeks) to ML is associated with decreased liver injury compared with SL in hospitalized children.