Inpatient outcomes of preterm infants receiving ω-3 enriched lipid emulsion (SMOFlipid): an observational study

Nalin Choudhary, Kenneth Tan, Atul Malhotra

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Neonatal units have started to switch from using conventional soy-based to alternate lipid emulsions, like SMOFlipid. SMOFlipid has been associated with an improvement in biochemical parameters and delays progression of parenteral nutrition-associated liver disease (PNALD). This retrospective epoch study aimed to compare clinically relevant neonatal outcomes in preterm infants (< 32 weeks), receiving SMOFlipid versus Intralipid. We compared clinical outcomes in two epochs—epoch 1 (Intralipid, October 2013–June 2015) versus epoch 2 (SMOFlipid, July 2015–March 2017). Primary outcome studied was mortality and rates of severe neonatal morbidities. Univariate and multivariate regression was conducted to determine risk for mortality and PNALD. A total of 222 infants (epoch 1, 123 versus epoch 2, 99) were included in the study. A higher incidence of late onset sepsis (56 versus 30%, p < 0.005) was observed in epoch 1. There was no significant difference in mortality or rates of any other severe neonatal morbidity. The type of lipid emulsion did not have a significant effect on mortality or PNALD on regression analysis. Conclusion: Use of SMOFlipid as the primary lipid emulsion seems to have minimal effect on rates of clinically important neonatal outcomes; however, long-term effects need to be further evaluated.What is Known:• Many neonatal units have started replacing traditional soy-based lipid formulations with SMOFlipid (ω-3 enriched lipid emulsion), as the primary lipid component in parenteral nutrition for preterm infants.• While there is evidence associating improved liver function and balanced essential fatty acid levels in infants receiving SMOFlipid, there is a lack of evidence evaluating relevant clinical outcomes in infants receiving SMOFlipid versus traditional lipid formulations.What is New:• The influence of SMOFlipid on a series of clinical outcomes in an at-risk preterm population is presented.• SMOFlipid appears to be well tolerated in preterm infants with minimal side effects, and some growth benefits seen.

Original languageEnglish
Pages (from-to)723-731
Number of pages9
JournalEuropean Journal of Pediatrics
Volume177
Issue number5
DOIs
Publication statusPublished - 1 May 2018

Keywords

  • Bronchopulmonary dysplasia
  • Intralipid
  • Liver disease
  • Parenteral nutrition

Cite this

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title = "Inpatient outcomes of preterm infants receiving ω-3 enriched lipid emulsion (SMOFlipid): an observational study",
abstract = "Neonatal units have started to switch from using conventional soy-based to alternate lipid emulsions, like SMOFlipid. SMOFlipid has been associated with an improvement in biochemical parameters and delays progression of parenteral nutrition-associated liver disease (PNALD). This retrospective epoch study aimed to compare clinically relevant neonatal outcomes in preterm infants (< 32 weeks), receiving SMOFlipid versus Intralipid. We compared clinical outcomes in two epochs—epoch 1 (Intralipid, October 2013–June 2015) versus epoch 2 (SMOFlipid, July 2015–March 2017). Primary outcome studied was mortality and rates of severe neonatal morbidities. Univariate and multivariate regression was conducted to determine risk for mortality and PNALD. A total of 222 infants (epoch 1, 123 versus epoch 2, 99) were included in the study. A higher incidence of late onset sepsis (56 versus 30{\%}, p < 0.005) was observed in epoch 1. There was no significant difference in mortality or rates of any other severe neonatal morbidity. The type of lipid emulsion did not have a significant effect on mortality or PNALD on regression analysis. Conclusion: Use of SMOFlipid as the primary lipid emulsion seems to have minimal effect on rates of clinically important neonatal outcomes; however, long-term effects need to be further evaluated.What is Known:• Many neonatal units have started replacing traditional soy-based lipid formulations with SMOFlipid (ω-3 enriched lipid emulsion), as the primary lipid component in parenteral nutrition for preterm infants.• While there is evidence associating improved liver function and balanced essential fatty acid levels in infants receiving SMOFlipid, there is a lack of evidence evaluating relevant clinical outcomes in infants receiving SMOFlipid versus traditional lipid formulations.What is New:• The influence of SMOFlipid on a series of clinical outcomes in an at-risk preterm population is presented.• SMOFlipid appears to be well tolerated in preterm infants with minimal side effects, and some growth benefits seen.",
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Inpatient outcomes of preterm infants receiving ω-3 enriched lipid emulsion (SMOFlipid) : an observational study. / Choudhary, Nalin; Tan, Kenneth; Malhotra, Atul.

In: European Journal of Pediatrics, Vol. 177, No. 5, 01.05.2018, p. 723-731.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Inpatient outcomes of preterm infants receiving ω-3 enriched lipid emulsion (SMOFlipid)

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AB - Neonatal units have started to switch from using conventional soy-based to alternate lipid emulsions, like SMOFlipid. SMOFlipid has been associated with an improvement in biochemical parameters and delays progression of parenteral nutrition-associated liver disease (PNALD). This retrospective epoch study aimed to compare clinically relevant neonatal outcomes in preterm infants (< 32 weeks), receiving SMOFlipid versus Intralipid. We compared clinical outcomes in two epochs—epoch 1 (Intralipid, October 2013–June 2015) versus epoch 2 (SMOFlipid, July 2015–March 2017). Primary outcome studied was mortality and rates of severe neonatal morbidities. Univariate and multivariate regression was conducted to determine risk for mortality and PNALD. A total of 222 infants (epoch 1, 123 versus epoch 2, 99) were included in the study. A higher incidence of late onset sepsis (56 versus 30%, p < 0.005) was observed in epoch 1. There was no significant difference in mortality or rates of any other severe neonatal morbidity. The type of lipid emulsion did not have a significant effect on mortality or PNALD on regression analysis. Conclusion: Use of SMOFlipid as the primary lipid emulsion seems to have minimal effect on rates of clinically important neonatal outcomes; however, long-term effects need to be further evaluated.What is Known:• Many neonatal units have started replacing traditional soy-based lipid formulations with SMOFlipid (ω-3 enriched lipid emulsion), as the primary lipid component in parenteral nutrition for preterm infants.• While there is evidence associating improved liver function and balanced essential fatty acid levels in infants receiving SMOFlipid, there is a lack of evidence evaluating relevant clinical outcomes in infants receiving SMOFlipid versus traditional lipid formulations.What is New:• The influence of SMOFlipid on a series of clinical outcomes in an at-risk preterm population is presented.• SMOFlipid appears to be well tolerated in preterm infants with minimal side effects, and some growth benefits seen.

KW - Bronchopulmonary dysplasia

KW - Intralipid

KW - Liver disease

KW - Parenteral nutrition

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