Effects of mixed oil emulsion on short-term clinical outcomes in premature infants: A prospective, multicenter, randomized controlled trial

被引：9

作者：

Yang, Qing ^{[1
,2
,3
]}

Kong, Juan ^{[4
]}

Bai, Rui-Miao ^{[5
]}

Yu, Wen-Ting ^{[6
]}

Zhang, Juan ^{[7
]}

Shen, Wei ^{[1
,2
,3
]}

Tang, Li-Xia ^{[1
,2
,3
]}

Zhu, Yao ^{[1
,2
,3
]}

Wang, Ya-Sen ^{[1
,2
,3
]}

Song, Si-Yu ^{[4
]}

Yang, Dong ^{[5
]}

Song, Shi-Rong ^{[6
]}

Zhang, Yi-Jia ^{[7
]}

Lin, Xin-Zhu ^{[1
,2
,3
]}

Wu, Fan ^{[4
]}

Li, Zhan-Kui ^{[5
]}

Mao, Jian ^{[6
]}

Tong, Xiao-mei ^{[7
]}

机构：

[1] Xiamen Univ, Women & Childrens Hosp, Sch Med, Dept Neonatol, Xiamen 361003, Peoples R China

[2] Xiamen key Lab perinatal neonatal Infect, Xiamen, Peoples R China

[3] Xiamen Clin Res Ctr Perinatal Med, Xiamen, Peoples R China

[4] Guangzhou Med Univ, Affiliated Hosp 3, Dept Neonatol, Guangzhou 510150, Peoples R China

[5] Northwest Womens & Childrens Hosp, Dept Neonatol, Xian 710061, Shanxi, Peoples R China

[6] China Med Univ, Shengjing Hosp, Dept Neonatol, Shenyang 110004, Liaoning, Peoples R China

[7] Peking Univ Third Hosp, Dept Pediat, Beijing 100191, Peoples R China

来源：

EUROPEAN JOURNAL OF CLINICAL NUTRITION | 2023年 / 77卷 / 08期

关键词：

NUTRITION-ASSOCIATED CHOLESTASIS; PRETERM INFANTS; LIPID EMULSION; FISH-OIL; BRONCHOPULMONARY DYSPLASIA; OLIVE OIL; SUPPLEMENTATION; UPDATE; ACID;

D O I：

10.1038/s41430-023-01288-6

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

ObjectiveThis study compared the clinical effects of two different lipid emulsions in premature infants with gestational age < 32 weeks (VPI) or birth weight < 1500 g (VLBWI) to provide an evidence-based medicine basis for optimizing intravenous lipid emulsion. MethodsThis was a prospective multicenter randomized controlled study. A total of 465 VPIs or VLBWIs, admitted to the neonatal intensive care unit of five tertiary hospitals in China from March 1, 2021 to December 31, 2021, were recruited. All subjects were randomly allocated into two groups, namely, medium-chain triglycerides/long-chain triglycerides (MCT/LCT) group (n = 231) and soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOF) group (n = 234). Clinical features, biochemical indexes, nutrition support therapy, and complications were analyzed and compared between the two groups. ResultsNo significant differences were found in perinatal data, hospitalization, parenteral and enteral nutrition support between the two groups (P > 0.05). Compared with the MCT/LCT group, the incidence of neonates with a peak value of total bilirubin (TB) > 5 mg/dL (84/231 [36.4% vs. 60/234 [25.6%]), a peak value of direct bilirubin (DB) >= 2 mg/dL (26/231 [11.3% vs. 14/234 [6.0%]), a peak value of alkaline phosphatase (ALP) > 900 IU/L (17/231 [7.4% vs. 7/234 [3.0%]), and a peak value of triglycerides (TG) > 3.4 mmol/L (13/231 [5.6% vs. 4/234[1.7%]]) were lower in the SMOF group (P < 0.05). Univariate analysis showed that in the subgroup analysis of < 28 weeks, the incidence of parenteral nutrition-associated cholestasis (PNAC) and metabolic bone disease of prematurity (MBDP) were lower in the SMOF group (P = 0.043 and 0.029, respectively), whereas no significant differences were present in the incidence of PNAC and MBDP between the two groups at > 28 weeks group (P = 0.177 and 0.991, respectively). Multivariate logistic regression analysis revealed that the incidence of PNAC (aRR: 0.38, 95% confidence interval [CI]: 0.20-0.70, P = 0.002) and MBDP (aRR: 0.12, 95% CI: 0.19-0.81, P = 0.029) in the SMOF group were lower than that in the MCT/LCT group. In addition, no significant differences were recorded in the incidence of patent ductus arteriosus, feeding intolerance, necrotizing enterocolitis (Bell's stage >= 2), late-onset sepsis, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity and extrauterine growth retardation between the two groups (P > 0.05). ConclusionsThe application of mixed oil emulsion in VPI or VLBWI can reduce the risk of plasma TB > 5 mg/dL, DB >= 2 mg/dL, ALP > 900 IU/L, and TG > 3.4 mmol/L during hospitalization. SMOF has better lipid tolerance, reduces the incidence of PNAC and MBDP, and exerts more benefits in preterm infants with gestational age < 28 weeks.

引用

页码：823 / 832

页数：10