SAFETY AND QUALITY OF INTRAVENOUS LIPIDS FOR NEWBORNS: CURRENT KNOWLEDGE AND FUTURE PROSPECTS

Abstract

. Premature birth leads to the developmentof "metabolic shock" in a newborn, the severity of whichis inversely opposite to the weight and gestational age.Infants lose the ability to receive nutrients naturally,transplacentally, and the ability to metabolize mother'smilk is limited due to immaturity. The growth up standardof a prematurely born child is intrauterine growth of thefetal brain and body, which requires not only a sufficientamount of essential nutrients, but also their qualitativecomposition. Nutritional support of premature newborns isa difficult task, especially if infants have perinatal diseasesor require mechanical ventilation, which makes theircatabolic state even worse. Stress limits the child's continuedphysical growth during the first few weeks after birth, andis associated with chronic morbidity and neurologicaldisability in the future. One, and sometimes the only way ofsupplying the main nutrients, is parenteral nutrition, highquality performance of which makes it possible to satisfymost of the nutritional needs of premature babies. In recentyears, high-quality parenteral nutrition protocols have beendeveloped, the adherence to which allows to achieve thegoal. They involve a rather aggressive approach to aminoacid and lipid infusion, but there is still concern about theuse of early parenteral nutrition. Especially restrictionsrelate to intravenous lipids, which are based on severaldogmas, indicating that lipid infusion can be associatedwith the damage of the lungs and liver tissues, as wellas the development of sepsis and thrombosis. There areseveral recent reviews that partially refute these dogmas.In our publication we would like to provide a short basicdata on the safety of lipid emulsions used in newborns, andalso to provide data on the positive effect of lipids on somebiochemical processes and conditions, with an emphasison their features, depending on the composition of the fatemulsion. The literature review can be used to view clinicalpractice, to search for optimal strategies of lipid emulsionsusage, taking into account their chemical components,which will improve the quality of nursing prematureinfants. The purpose of this work is to analyze scientificliterature sources to study and systematize data on modernaspects of the use of lipid emulsions in newborns.