MIXED MCT/LCT LIPID EMULSION USE IN SICK VLBW INFANTS

Abstract

Undernutrition is common in sick VLBW infants requiring parenteral nutrition (PN). Lipid-free PN leads to poor energy intake but lipid has been associated with increased incidences of infection and BPD. Medium chain triglycerides (MCT) are metabolised faster than long chain (LCT). We therefore designed a new PN regimen, with use of a 50 % MCT emulsion from day 2 and in greater amounts, and compared thiB to a conventional PN regimen with 100% LCT emulsion. Sick VLBW infants were randomised to this new PN regimen (MCT) or control (LCT) groups; Lipofundin MCT/LCT (B Braun) was used in the MCT group (n=64) and Intralipid (Kabi Vitrum) in the LCT group (n=61). The MCT group had a mean BW of 925 g compared to 933 g in the LCT group. Mean energy intakes whilst receiving PN were greater (p < 0.001) in the MCT group at days 7, 14, 21, 28, 35 and 42. The incidences of BPD were 29 % in the MCT group and 29% in the LCT group (ns), with infection rates of 63 % and 74 % respectively (ns). There were no significant increases in incidences of hyperlipidaemia or hyperketonaemia in the MCT group. We conclude that liberal MCT emulsion usage lessens undernutrition without adverse clinical or metabolic sequelae in sick preterms.