META-ANALYSES OF EFFECTS OF EARLY OR LATE INTRODUCTION OF INTRAVENOUS LIPID TO PRETERM INFANTS ON MORTALITY AND CHRONIC LUNG DISEASE

Abstract

254 Background: Timing after birth of the intravenous use of lipid emulsion for preterm infants has been controversial. Some authors suggest early introduction of intravenous lipid is associated with increased mortality and incidence of chronic lung disease (CLD). Aims: To assess the effects of early (< 5 days) or late (> 5 days) introduction of intravenous lipid emulsion to preterm infants on the incidences of death and CLD. Methods: Meta-analyses of all randomised controlled trials (RCT) were performed after carrying out searches of personal files, Medline, Embase and Science Citation Index. To identify suitable trials, two independent researchers used the following key words: intravenous fat emulsions and/or lipids; infant - premature and/or low birth weight; CLD or bronchopulmonary dysplasia; death or mortality; RCT. Data were independently abstracted by the same two researchers and any controversy resolved by consensus. Relative risk(RR) with 95% confidence intervals (CI) were calculated using Revman ® for death, CLD at 28 days of life (CLD 28 days) and CLD at 36 weeks corrected age(CLD 36 weeks). Results: Six RCTs were identified including 522 infants. There was some variation between the trials in the timing of early (days 1 to 5) and late (days 5 to 14) introduction of intravenous lipids. Results of meta-analyses are shown in the table below:Conclusion: To date, 522 preterm infants have been enrolled in RCTs designed to assess the effect of early versus late introduction of intravenous lipids. These meta-analyses suggest that early introduction of intravenous lipid to preterm infants has no adverse effects on the incidence of death or CLD.