TY - JOUR
T1 - A Comparison of Smoflipid® and Intralipid® in the Early Management of Infants with Intestinal Failure
AU - Casson, Cameron
AU - Nguyen, Van
AU - Nayak, Pritha
AU - Channabasappa, Nandini
AU - Berris, Kaitlin
AU - Panczuk, Julia
AU - Bhiladvala, Cyrus
AU - Dasgupta, Tisha
AU - Piper, Hannah G.
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/1
Y1 - 2020/1
N2 - Purpose: Cholestasis is problematic for infants with intestinal failure (IF). The soy-based lipid Intralipid® (IL) has been implicated. An alternative, Smoflipid® (SMOF), is increasingly used. However, its role in cholestasis prevention is unclear. This study compares the incidence and degree of cholestasis between infants with IF receiving SMOF or IL. Methods: Infants with IF receiving SMOF or IL during the first 8 weeks of parenteral nutrition (PN) support between 2014 and 2017 were reviewed. Clinical characteristics, cholestasis incidence (conjugated bilirubin (Cbili) > 2 mg/dL for > 2 weeks), and nutritional parameters were compared using Welch's t-test. Results: 91% (21/23) of IL and 76% (16/21) of SMOF babies became cholestatic (p = 0.18). There was no significant difference in median peak Cbili, but SMOF babies normalized more quickly (p = 0.04). Median z-scores for weight were similar throughout the study. SMOF patients getting full PN had a lower incidence of cholestasis compared to IL patients (78% vs. 92%, p = 0.057), but those with cholestasis had similar peak Cbili, time to resolution, and growth. Conclusion: Early use of Smoflipid® did not reduce the incidence of cholestasis compared to Intralipid® in infants with IF, but hyperbilirubinemia did resolve more quickly. SMOF may be most beneficial for infants tolerating no enteral nutrition. Level of Evidence: Level III Retrospective Comparative Treatment Study. Type of Study: Retrospective Review.
AB - Purpose: Cholestasis is problematic for infants with intestinal failure (IF). The soy-based lipid Intralipid® (IL) has been implicated. An alternative, Smoflipid® (SMOF), is increasingly used. However, its role in cholestasis prevention is unclear. This study compares the incidence and degree of cholestasis between infants with IF receiving SMOF or IL. Methods: Infants with IF receiving SMOF or IL during the first 8 weeks of parenteral nutrition (PN) support between 2014 and 2017 were reviewed. Clinical characteristics, cholestasis incidence (conjugated bilirubin (Cbili) > 2 mg/dL for > 2 weeks), and nutritional parameters were compared using Welch's t-test. Results: 91% (21/23) of IL and 76% (16/21) of SMOF babies became cholestatic (p = 0.18). There was no significant difference in median peak Cbili, but SMOF babies normalized more quickly (p = 0.04). Median z-scores for weight were similar throughout the study. SMOF patients getting full PN had a lower incidence of cholestasis compared to IL patients (78% vs. 92%, p = 0.057), but those with cholestasis had similar peak Cbili, time to resolution, and growth. Conclusion: Early use of Smoflipid® did not reduce the incidence of cholestasis compared to Intralipid® in infants with IF, but hyperbilirubinemia did resolve more quickly. SMOF may be most beneficial for infants tolerating no enteral nutrition. Level of Evidence: Level III Retrospective Comparative Treatment Study. Type of Study: Retrospective Review.
KW - Cholestasis
KW - Intestinal failure-associated liver disease
KW - Lipid emulsion
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U2 - 10.1016/j.jpedsurg.2019.09.073
DO - 10.1016/j.jpedsurg.2019.09.073
M3 - Article
C2 - 31672409
AN - SCOPUS:85074483466
SN - 0022-3468
VL - 55
SP - 153
EP - 157
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 1
ER -