A Comparison of Smoflipid® and Intralipid® in the Early Management of Infants with Intestinal Failure.

Autor: Casson C; Division of Pediatric Surgery, University of Texas Southwestern/Children's Health, Dallas, TX, USA., Nguyen V; Division of Gastroenterology, University of Texas Southwestern/Children's Health, Dallas, TX, USA., Nayak P; Division of Neonatology, University of Texas Southwestern/Children's Health, Dallas, TX, USA., Channabasappa N; Division of Gastroenterology, University of Texas Southwestern/Children's Health, Dallas, TX, USA., Berris K; Division of Neonatology, University of British Columbia/BC Women's Hospital and Health Center, Vancouver, BC, Canada., Panczuk J; Division of Neonatology, University of British Columbia/BC Women's Hospital and Health Center, Vancouver, BC, Canada., Bhiladvala C; Division of Pediatric Surgery, University of British Columbia/BC Children's Hospital, Vancouver, BC, Canada., Dasgupta T; Division of Pediatric Surgery, University of British Columbia/BC Children's Hospital, Vancouver, BC, Canada., Piper HG; Division of Pediatric Surgery, University of British Columbia/BC Children's Hospital, Vancouver, BC, Canada. Electronic address: hannah.piper@cw.bc.ca.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2020 Jan; Vol. 55 (1), pp. 153-157. Date of Electronic Publication: 2019 Oct 25.
DOI: 10.1016/j.jpedsurg.2019.09.073
Abstrakt: Purpose: Cholestasis is problematic for infants with intestinal failure (IF). The soy-based lipid Intralipid® (IL) has been implicated. An alternative, Smoflipid® (SMOF), is increasingly used. However, its role in cholestasis prevention is unclear. This study compares the incidence and degree of cholestasis between infants with IF receiving SMOF or IL.
Methods: Infants with IF receiving SMOF or IL during the first 8 weeks of parenteral nutrition (PN) support between 2014 and 2017 were reviewed. Clinical characteristics, cholestasis incidence (conjugated bilirubin (Cbili) >2 mg/dL for >2 weeks), and nutritional parameters were compared using Welch's t-test.
Results: 91% (21/23) of IL and 76% (16/21) of SMOF babies became cholestatic (p = 0.18). There was no significant difference in median peak Cbili, but SMOF babies normalized more quickly (p = 0.04). Median z-scores for weight were similar throughout the study. SMOF patients getting full PN had a lower incidence of cholestasis compared to IL patients (78% vs. 92%, p = 0.057), but those with cholestasis had similar peak Cbili, time to resolution, and growth.
Conclusion: Early use of Smoflipid® did not reduce the incidence of cholestasis compared to Intralipid® in infants with IF, but hyperbilirubinemia did resolve more quickly. SMOF may be most beneficial for infants tolerating no enteral nutrition.
Level of Evidence: Level III Retrospective Comparative Treatment Study.
Type of Study: Retrospective Review.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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