Abstract
IntroductionStrategies to treat intestinal failure associated liver disease (IFALD) manipulate dose or composition of parenteral lipids. We compared low dose omega‐6 (soybean oil), low dose omega‐3 (fish oil) and standard dose therapies using soybean or a combination of soybean, medium chain triglycerides, olive and fish oil, on liver and nutritional outcomes in neonates.Materials and MethodsNeonatal pigletswere allocated to: Group 1 (n=6) Omegaven® at 5 g/kg/d, Group 2 (n=8) Intralipid® at 5 g/kg/d, Group 3 (n=9) Intralipid® at 10 g/kg/d, Group 4 piglets (n=10) SMOFlipid ® at 10g/kg/d and Group 5 sow‐reared controls (n=8). After 14 days of total parenteral nutrition we compared bilirubin, bile flow, weight and brain weight.Results by Group (mean/SD) 1 2 3 4 5 Total Bilirubin (microM/L) 7.0a (5.3) 10.8a (3.2) 21.1b (10.7) 4.0c (1.2) 8.2a (3.9) Bile flow (mcg/g liver) 12.3a (6.8) 7.9a (3.8) 5.4b (4.0) 13.5a (6.6) 9.0a (1.9) Total weight gain (kg) 2.7a (0.2) 2.4a (0.3) 2.2a (0.5) 3.0c (0.3) 3.9b (0.9) Brain weight (g) 35.3a (1.8) 36.3a (3.3) 41.6ab (4.6) 44.2b (3.4) 45.9b (3.4) Superscripts refer to differences by ANOVA p<0.05 DiscussionGroups 1, 2 and 4 were equally effective in preventing IFALD. Based on weight gain and final brain weight SMOFlipid ® provides beneficial nutritional support to vulnerable neonates, while protecting from cholestasis.The source of research support is CIHR with Fresenius KabiGrant Funding Source:CIHR
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