Background/Objectives: The aim of this study was to research and draw conclusions about the effect of a parenteral nutrition (PN) fat emulsion, rich in o-3 fatty acids, on the antioxidant markers of preterm infants, when compared with a standard fat emulsion. This was a double-blind, parallel-group study conducted in Athens, Greece, using an equal randomization method. Subjects/Methods: Thirty-eight infants were selected using a double-blind method and a computer-generated randomization list. Both groups received PN, based on the same protocols. Group A received SMOFlipid fat emulsion, while group B received the standard fat emulsion (Intralipid). Serum levels of vitamin A, E and total antioxidant potential (TAP) were measured on days 0, 7 and 14 of PN support. Clinical and biochemical data were collected on days 0, 14 and on the day of discharge. Results: Serum levels of vitamin E and A were significantly increased in group A, while only vitamin A serum level was increased in group B on the fourteenth day (group A: vitamin E: P-value ¼ 0.002, vitamin A: P-value ¼ 0.000, group B: vitamin E: P-value ¼ 0.065, vitamin A: P-value ¼ 0.000). TAP was increased only in the intervention group (group A: P-value ¼ 0.000, group B: P-value ¼ 0.287). Mild anemia was developed in both groups, while no differences were detected in the infection rate, days of hospitalization, days of ventilator support and days of phototherapy. Conclusions: Oxidative stress was significantly reduced in those neonates fed with o-3 fatty acids, whereas no effect was observed in the neonates fed with standard lipids. Intervention had no effect on infants' growth and clinical outcome.

In VLBW infants, the MCT/ω-3-PUFA-containing LE administration is associated with decreased BPD and more favorable lipoprotein profile. Although a trend toward a lower incidence of cholestasis was observed, a preventive effect of MCT/ω-3-PUFA-containing LE on parenteral nutrition-associated cholestasis is not supported.

The use of standardized protocols in preterm neonates resulted in more adequate provision of nutrients, weight gain and better blood count profile compared with protocols prescribed by individual physicians.

The aim of the study was to assess the stability of all-in-one (AIO) parenteral admixture used for neonates, containing SMOFlipid, an alternative to soybean, an α-tocopherol-enriched lipid emulsion. SMOFlipid, consisting of soybean oil, medium chain triglycerides, olive oil and fish oil, was introduced commercially in 2005. Stability assays consisted of the assessment of the admixture's macroscopic aspect, droplet size distribution, pH, peroxide value and α-tocopherol concentration. The admixture was stored at room temperature or at 4°C and analysed over time (0, 24 and 48 h). The SMOFlipid-containing AIO parenteral admixture was shown to be physicochemically stable. All changes were reversible, the droplet size was under the upper limit (0.5 µm) set by the US Pharmacopeia, maximum loss for vitamin E was 25% and the lipid peroxidation occurred within 24 h after preparation. In conclusion, the addition of SMOFlipid to an AIO parenteral admixture for neonates did not affect its physicochemical stability, and it was safe for administration on the first day of its preparation.

Due to insufficient exposure to sunlight and a diet not enriched with vitamin D, bedridden pregnant women suffer from vitamin D deficiency and pregnancy complications lead often to birth of preterm neonates with the same deficiency. Mothers should increase the total amount of vitamin D intake (food and supplement).