Effect of high-dose second-generation fat emulsion usage on very low birth weight infants

Abstract

Objective To explore the efficacy and safety of high-dose second-generation fat emulsion usage on the very low birth weight premature infants. Methods A total of 88 premature infants with very low birth weight(VLBW) in Neonatal Intensive Care Unit (NICU)of Fujian Provincial Maternity and Children Hospital, Affiliated Hospital of Fujian Medical University from December 2013 to December 2014 were randomly divided into experimental group and control group, with 44 cases in each group according to the table of random number.The experimental group received intravenous nutrition with 200 g/L second-generation fat emulsion within 24 hours after birth, the initial dose was 2.0 g/(kg·d) with an increase of (0.5-1.0) g/(kg·d) daily, the maximum dose was 3.5 g/(kg·d); the control group received intravenous nutrition with 200 g/L second-generation fat emulsion 24 hours later after birth, the initial dose was 0.5 g/(kg·d) with an increase of 0.5 g/(kg·d) daily, the maximum dose was 3.5 g/(kg·d). The other intravenous nutrition methods were same.The general conditions at birth, blood biochemical parameters, growth parameters and complications were compared between the 2 groups. Results The mean value of intravenous nutrition duration, length of stay, the glucose infusion rates of postnatal days 6 and 7, the serum triglyceride levels of postnatal days 7, chest circumference of the fourth weeks, the incidence of the low triiodothyronine(T3) syndrome and parenteral nutrition associated cholestasis(PNAC) were (22.27±7.17) d, (37.75±12.28) d, (8.10±0.92) mg/(kg·min), (8.49±1.06) mg/(kg·min), 0.18(0.03-0.59) mmol/L and (27.21±1.62) cm in the experimental group respectively, but (27.36±11.37) d, (44.36±16.45) d, (7.98±0.79) mg/(kg·min), (8.22±0.76) mg/(kg·min), 0.28(0.07-0.99) mmol/L and (26.56±0.96) cm in the control group, respectively, and the differences were statistically significant between the 2 groups(t=2.512, 5.403, 4.314, 9.705, 696.500, 6.668, all P 0.05). Conclusions The high-dose second-generation fat emulsion usage[the initial dose 2.0 g/(kg·d)]in VLBW infants is safe and well tolerated.Advisable parenteral nutrition support strategy can promote growth of VLBW infants, shorten the intravenous nutrition duration and length of stay, reduce the incidence of the low T3 syndrome and PNAC, which has no influence on the incidence rates of other complications. Key words: Infant, premature; Very low birth weight; Parenteral nutrition; Growth; Complication