Comparison of the impact of different fat emulsions on clinical outcomes in preterm infants with varying duration of parenteral nutrition: a randomized controlled multicenter study
LIN Rong1, YANG Qing1, WANG Ya-Sen1, SHEN Wei1, LIN Xin-Zhu1, SONG Si-Yu2, KONG Juan2, WU Fan2, YANG Dong3, BAI Rui-Miao3, LI Zhan-Kui3, SONG Shi-Rong4, YU Wen-Ting4, MAO Jian4, ZHANG Yi-Jia5, ZHANG Juan5, TONG Xiao-Mei5
.Department of Neonatology, Women and Children's Hospital, Xiamen University/Xiamen Maternal and Child Health Hospital/Xiamen Key Laboratory of Perinatal Neonatal Infection/Xiamen Clinical Research Center for Perinatal Medicine, Xiamen, Fujian 361003 .Department of Neonatology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
Abstract Objective To compare the impact of two types of fat emulsion on clinical outcomes in preterm infants with varying duration of parenteral nutrition (PN). Methods Preterm infants meeting the inclusion criteria were randomly assigned to two groups: medium/long-chain triglyceride fat emulsion (referred to as MCT/LCT) group or multi-oil fat emulsion (containing soybean oil, medium-chain triglycerides, olive oil, and fish oil; referred to as SMOF) group. The infants were stratified into groups based on the duration of PN (15-21 days, 22-28 days, and ≥29 days). Clinical characteristics, nutritional status, biochemical indicators, and clinical outcomes were compared between the two groups. Results Compared with the MCT/LCT group, the SMOF group had lower peak levels of triglyceride during the hospital stay in preterm infants with PN of 15-21 days, 22-28 days, and ≥29 days, respectively (P<0.05). Logistic regression trend analysis showed that with a longer duration of PN, the risk of parenteral nutrition-associated cholestasis (PNAC) and bronchopulmonary dysplasia (BPD) significantly increased in the MCT/LCT group (P<0.05), while the risk of brain injury did not significantly change (P>0.05). In the SMOF group, the risks of PNAC and BPD did not significantly change with a longer duration of PN (P>0.05), but the risk of brain injury significantly decreased (P=0.006). Conclusions Compared to MCT/LCT, SMOF have better lipid tolerance. With a longer duration of PN, SMOF does not increase the risks of PNAC and BPD and had a protective effect against brain injury. This suggests that in preterm infants requiring long-term PN, the use of SMOF is superior to MCT/LCT.
LIN Rong,YANG Qing,WANG Ya-Sen et al. Comparison of the impact of different fat emulsions on clinical outcomes in preterm infants with varying duration of parenteral nutrition: a randomized controlled multicenter study[J]. CJCP, 2023, 25(9): 901-908.
LIN Rong,YANG Qing,WANG Ya-Sen et al. Comparison of the impact of different fat emulsions on clinical outcomes in preterm infants with varying duration of parenteral nutrition: a randomized controlled multicenter study[J]. CJCP, 2023, 25(9): 901-908.
