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Essential Fatty Acid Deficiency with SMOFlipid Reduction in an Infant with Intestinal Failure–Associated Liver Disease
Author(s) -
Memon Naureen,
Hussein Karen,
Hegyi Thomas,
Herdt Aimee,
Griffin Ian J.
Publication year - 2019
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1432
Subject(s) - intestinal failure , cholestasis , liver disease , soybean oil , medicine , fish oil , parenteral nutrition , endocrinology , infant formula , fatty liver , disease , gastroenterology , biochemistry , biology , fish <actinopterygii> , pediatrics , fishery
Multicomponent lipid emulsions, such as SMOFlipid, contain intermediate amounts of essential fatty acids (EFAs) compared with traditional soybean–oil based lipid emulsions and 100% fish–oil lipid emulsions. We describe the development of moderate EFA deficiency (EFAD) and slow weight gain in an infant with intestinal failure–associated liver disease managed with SMOFlipid reduction (1 g/kg/d). Once SMOFlipid dosage was increased (2–3 g/kg/d), EFA levels normalized, adequate growth resumed, and the infant's cholestasis resolved. We recommend avoiding lipid reduction of SMOFlipid, which not only increases the risk for EFAD, but also is unnecessary given that cholestasis can be reversed on conventional doses of SMOFlipid.