SMOFlipid Impact on Growth and Neonatal Morbidities in Very Preterm Infants

Abstract

The soybean oil, medium-chain triglycerides, olive oil, and fish oil lipid (SMOFlipid) is increasingly being used worldwide without definite evidence of its benefits. We examined the effect of SMOFlipid on growth velocity and neonatal morbidities in very preterm infants. Very preterm infants who received soybean-based lipid emulsion between January 2015 and 2018 were compared with those who received SMOFlipids between 2019 and January 2022 in our neonatal tertiary center. Linear regression analysis was conducted to analyze the association between type of lipid emulsion and growth velocity. Modified log-Poisson regression with generalized linear models and a robust variance estimator (Huber–White) were applied to adjust for potential confounding factors. A total of 858 infants met our inclusion criteria. Of them, 238 (27.7%) received SMOFlipid. SMOFlipid was associated with lower growth velocity between birth and 36-week corrected gestational age compared with intralipid Δ weight z-score (adjusted mean difference (aMD) −0.67; 95% CI −0.69, −0.39). Subgroup analysis indicated that mainly male infants in the SMOFlipid–LE group had a lower Δ weight z-score compared to those in the intralipid group (p < 0.001), with no difference observed in females (p = 0.82). SMOFlipid was associated with a lower rate of bronchopulmonary dysplasia (BPD) (aRR 0.61; 95% CI 0.46, 0.8) and higher rate of late-onset sepsis compared with intralipid (aRR 1.44; 95% CI 1.22–1.69). SMOFlipid was associated with lower growth velocity and BPD but higher rate of late-onset sepsis—it is a double-edged sword.

WITHDRAWN: Impact of SMOFlipid Emulsion Integration in Total Parenteral Nutrition on Inpatient Outcomes and Economic Burden for Preterm Neonates: A Retrospective Cohort Study

“…The reduction in the LOS with the use of SMOFlipid was confirmed in previous studies. (28,31) Our study also found that males were 1.6 times more likely to develop sepsis relative to females, but this increase in risk was not statistically significant (p value = 0.216). This agrees with a previous study that showed a higher incidence of sepsis in males than in females (1.7:1).…”

“…This finding is consistent with previous studies that indicated that SMOFlipid has a protective effect against infection. (28)(29)(30) When analyzing the impact of SMOFlipid on hospitalization, the gamma regression analysis indicated that infants receiving TPN with SMOFlipid had a mean reduction in hospitalization by approximately 4.12 days compared to those without SMOFlipid. However, this reduction was not statistically significant (p = 0.08).…”

Comparative Study of Nanoparticle Blood Circulation after Forced Clearance of Own Erythrocytes (Mononuclear Phagocyte System-Cytoblockade) or Administration of Cytotoxic Doxorubicin- or Clodronate-Loaded Liposomes

“…For example, intralipid, as well as SMOFlipid (soy oil, medium-chain triglyceride, olive, and fish-oil-based lipid emulsion), nutritional supplements known to be taken up by Kupffer cells in the liver, were reported to act as an inhibitor for their phagocytic activity [ 17 , 34 ]. However, the safety of both formulations raised concerns [ 35 , 36 ]. Another approach is the use of “decoy” nanoparticles that block the MPS, luring the MPS cells away from the intended nanodrug, and thus, prolonging its circulation time [ 37 , 38 ].…”

Association between SMOFlipid and impaired brain development on term-equivalent age brain magnetic resonance imaging in very preterm infants

“…Our recent study found SMOFlipid was associated with lower bronchopulmonary dysplasia (BPD). However, it was associated with a higher frequency of late-onset sepsis (LOS) and delayed growth velocity [11]. A new study reported no alteration in BPD and mortality in premature infants receiving SMOFlipid during their hospital stay [12].…”