Analysis of risk factors for lipid intolerance of intravenous fat emulsion in very low birth weight infants

Abstract

In order to prevent fatty acid deficiency and to supply enough energy, intravenous fat emulsion is necessary for parenteral nutrition in preterm neonates. However, parenteral administration of intravenous fat emulsion can induce lipid intolerance. The purpose of this study was to analyze risk factors for lipid intolerance in very low birth weight infants. This retrospective study included 80 preterm neonates whose birth weight was less than 1,500 g. Subjects were divided into 2 categories: those with a serum triglyceride level of ≥ 200 mg/dl (n = 33, 41%) and those with a serum triglyceride level of < 200 mg/dl (n = 47, 59%). We conducted logistic regression analysis using variables which were significant in univariate analysis. All statistical analyses were processed in SPSS version 19.0. Four risk factors for lipid intolerance were obtained through analysis of the electronic medical record. Lipid intolerance occurred more frequently in neonates with sepsis; those with a birth weight less than 1,000 g; those who was administered intravenous fat emulsion more than 2.6 g/kg/day; and those whose gestational age was less than 28 weeks. It is suggested that serum triglyceride levels should be closely monitored to prevent lipid intolerance in preterm neonates with the aforementioned characteristics.

Influence of i.v. lipid emulsion on lipoprotein subclass in preterm infants

“…This implies that the triglyceride content in the larger HDL actually decreased as the volume of lipid emulsion provided to the infants increased. VLBWI also have low clearance of lipid emulsion from the blood, and this is directly related to birthweight and to their degree of immaturity . In the present study, the range of infant characteristics (26–28 weeks gestational age; 825–1,243 g birthweight; mothers’ age 28–35 years) was narrow, which may minimize their influence on the results.…”

“…Thus, the rate (or dose) at which lipid emulsions can be infused is limited by the half‐life of the triglycerides in the infants’ blood. The clearance of lipid emulsion from the blood of VLBWI is much lower than in average birthweight infants, and is directly related to birthweight and to the degree of immaturity . Therefore, lower birthweight infants have a higher risk of hypertriglyceridemia …”

“…The clearance of lipid emulsion from the blood of VLBWI is much lower than in average birthweight infants, and is directly related to birthweight and to the degree of immaturity. 3,4 Therefore, lower birthweight infants have a higher risk of hypertriglyceridemia. 5 Recently it has become possible to measure the triglyceride and cholesterol content in each subclass of lipoprotein.…”

Pemberian Lipid Parenteral secara Dini dan Agresif pada Bayi Prematur: Hubungannya dengan Kejadian Sepsis

“…25 Intoleransi lipid yang ditandai dengan terjadinya hipertrigliserida dapat memengaruhi permukaan dan komposisi membran sel fagosit sehingga mengganggu fungsinya. 26,27 Penelitian oleh Freeman dkk 28 menunjukkan bahwa pemberian lipid parenteral berhubungan dengan terjadinya bakteremia akibat Stafilokolus koagulase-negatif, akan tetapi penggunaan kateter intravena berbahan dasar Teflon dipikirkan berkontribusi dalam hal ini.…”

Nutrición intrahospitalaria del prematuro. Recomendaciones de la Rama de Neonatología de la Sociedad Chilena de Pediatría

“…of Pages 17 Nutrición intrahospitalaria del prematuro 3 Suspender o bajar a 0,5 basados en lípidos predominantes en omega 6 como son los de soya 8 . Los niveles altos de triglicéridos están menos asociados a los aportes de lípidos que a características clínicas del paciente: sepsis, premadurez extrema, restriccion de crecimiento intrauterino (RCIU), hipotermia, hipoxia se asocian significativamente a mayores niveles de triglicéridos 9 . En caso de sepsis, la disminución de los niveles de lípidos a 1 g/kg/día produce menor duración de hemocultivos positivos, pero concomitantemente menor ganancia de peso 10 .…”