Intravenous fish oil containing lipid emulsion attenuates inflammatory cytokines and the development of bronchopulmonary dysplasia in very premature infants: A double-blind, randomized controlled trial. Issue 3 (June 2019)

• Record Type: Journal Article
• Authors: Hsiao, Chien-Chou; Lin, Hung-Chih; Chang, Yu-Jun; Yang, Shih-Pan; Tsao, Lon-Yen; Lee, Cheng-Han; Chen, Hsiao-Neng; Chen, Jia-Yuh; Tsai, Yi-Giien
• Is Part Of: Clinical nutrition. Volume 38:Issue 3(2019)
• Page Start: 1045
• Page End: 1052
• Publication Date: 2019-06
• Subjects: Fish oil -- DHA -- n-3 long-chain PUFA -- Premature infants -- Bronchopulmonary dysplasia; AA arachidonic acid -- BPD bronchopulmonary dysplasia -- DHA docosahexaenoic acid -- EPA eicosapentaenoic acid -- FO Fish oil -- IL interleukin -- n-3 long-chain PUFA omega-3 long-chain polyunsaturated fatty acids -- LE lipid emulsion -- SO soybean oil -- TPN total parenteral nutrition; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2018.06.929
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background & aims: Preterm infants have lower levels of long-chain polyunsaturated fatty acids (LCPUFAs). Supplementing very premature infants with intravenous lipid emulsions that fish oil, which is rich in n-3 LC-PUFAs, may decrease bronchopulmonary dysplasia (BPD) by modulating inflammation and neonatal immune function. Methods: Sixty very low birth weight (VLBW) premature infants requiring ventilator support were randomized in a double-blind manner to 2 groups and received total parenteral nutrition with fish oil containing LE (intervention group, n = 30) or soybean oil containing LE (control group, n = 30) for 7 days. Blood samples and bronchoalveolar lavage fluid (BALF) were obtained for assay on day 1 and 7 days after LE. The primary outcome was to compare the levels of interleukin (IL)-1β and IL-6 in serum and BALF. Secondary outcomes were to compare mortality and co-morbidities. Results: The levels of IL-1β and IL-6 in serum and BALF were significantly lower in the intervention group at day 8 ( p < 0.05). The incidence of BPD in the intervention group compared to the control group was 13.3% versus 36.7% ( p = 0.04; odds ratio [OR], 0.36; 95% confidence interval [CI], 0.21–0.86). The duration of ventilator support and oxygen use was significantly less in the intervention group than in the control group ( p < 0.05). The level of alanine aminotransferase was significantly lower in the intervention group on day 8 ( p = 0.031). Conclusions: In very premature infants, early administration of fish oil containing LE significantly decreased IL-1β and IL-6 levels in serum and BALF and was associated with shorter duration of ventilator support and less bronchopulmonary dysplasia (BPD). Trial registration number: ISRCTN 11427103.