Effect of parenteral lipids on essential fatty acid deficiency in pediatric intestinal failure: A retrospective cohort study.

Autor: Johnson P; Division of Pharmacy, American Family Children's Hospital, Madison, Wisconsin, USA., Phillips VL; Division of Pharmacy, The Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA., Lamb N; Division of Pharmacy, The Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA., Guo K; Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Zhao L; Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.; Division of Biostatistics, Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA., Brennan KM; Division of Gastroenterology, The Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA., Prozialeck JD; Division of Gastroenterology, The Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA., Cohran VC; Division of Gastroenterology, The Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2024 Oct; Vol. 48 (7), pp. 793-801. Date of Electronic Publication: 2024 Aug 08.
DOI: 10.1002/jpen.2678
Abstrakt: Background: Pediatric patients with intestinal failure require long-term parenteral nutrition owing to impaired enteral nutrition absorption. A potential complication is essential fatty acid deficiency (EFAD), resulting from decreased linoleic and α-linolenic acid concentrations and defined by an increased triene:tetraene ratio (TTR; Mead acid:arachidonic acid). Historically, soybean oil lipid emulsion (SOLE) was the only commercially available parenteral lipid in the United States. Recently, a composite lipid emulsion (CLE) and fish oil lipid emulsion (FOLE) received US Food and Drug Administration approval. This study investigated whether lipid emulsion regimen impacts EFAD incidence in pediatric patients with intestinal failure.
Methods: This study was a 10-year retrospective cohort study of pediatric patients with intestinal failure who received parenteral SOLE, CLE, or FOLE. The primary outcome was EFAD incidence, defined as a TTR ≥ 0.2. Secondary outcomes included TTR ≥ 0.05, cholestasis incidence, lipid dose effect on EFAD incidence, and fatty acid parameter differences.
Results: A total of 144 fatty acid profiles from 47 patients were reviewed. EFAD did not occur in any lipid emulsion group. There were no differences in the incidence of TTR ≥ 0.05 or cholestasis. The effect of dose could not be evaluated because of no EFAD incidence. Lastly, although each group had varied fatty acid parameters, none saw decreased essential fatty acid levels.
Conclusion: This study found that, with close monitoring, the lipid emulsion regimen did not impact EFAD incidence. This suggests that FOLE and CLE do not increase EFAD risk compared with SOLE in pediatric patients with intestinal failure.
(© 2024 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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