Comparison of The Effects of Fish Oil Containing Multicomponent And Standard Lipid Emulsion on Parenteral Nutrition Associated Cholestasis

INTRODUCTION: To compare the effect of a multicomponent parenteral lipid emulsion (PLE) with a standard PLE in case of cholestasis induced by longterm use of parenteral nutrition (PN) in infants who need surgical procedures.
METHODS: We conducted a retrospective study in neonatal intensive care unit (NICU) between January 2011 and February 2012. The patients
with surgical procedures and need for longterm PN (at least 2 weeks) at NICU were enrolled in the study. Group 1: given standard lipid emulsion, in addition to the standard treatment of cholestasis, Group 2: given multicomponent lipid emulsion (soybean oil, medium chain triglyceride, olive and lipid fish oil) in addition to the standard treatment of cholestasis. Period of cholestasis and prognosis data were compared during follow-up in NICU.
RESULTS: A total of 24 patients (Group 1 (n = 11) and Group 2 (n = 13)) were included in the study. Period of cholestasis were similar between groups. Despite the inequality between gestational age and birthweight among groups (gestational age 36±4.3 and 30.3±3.4 weeks and p=0,047, birth weight mean 2395±635 and 1404 ±670 g, p=0.03, respectively Group 1 and 2), total non-feeding time (Group 1: 10 ± 3.3 days; Group 2: 16.3 ± 10.6 days) and total duration of PN (group 1: 20 ± 4.6 days; Group 2: 25.8 ± 17 days) and mortality rates were compared between the groups and there was no statistically difference. There were no short-term adverse effects identified due to the use of multi-component PLE.
DISCUSSION AND CONCLUSION: No additional contribution of multicomponent PLE than standard PLE to the treatment of cholestasis could be shown at our study. We think that inequality among groups may effect these results.