Premium
The Effect of Parenteral Lipid Emulsions on Pulmonary Hemodynamics and Eicosanoid Metabolites in Preterm Infants
Author(s) -
Vasudevan Chakrapani,
Johnson Kathryn,
Miall Lawrence S.,
Thompson Douglas,
Puntis John
Publication year - 2013
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533613507285
Subject(s) - medicine , eicosanoid , eicosanoid metabolism , pulmonary artery , linoleic acid , thromboxane , prostaglandin , anesthesia , arachidonic acid , fatty acid , biochemistry , biology , platelet , enzyme
Background: Soy‐based intravenous fat emulsion (IVFE) is known to cause a rise in pulmonary artery pressure in the preterm infant, thought to be mediated through eicosanoid metabolites of linoleic acid. We compared the effect of soy‐based IVFE and an olive‐oil‐based IVFE containing less than half the content of linoleic acid on pulmonary artery pressure and eicosanoid metabolites in preterm infants receiving parenteral nutrition. Methods: In this pilot study at a regional neonatal intensive care unit (ICU), infants received either a soy‐based or olive‐oil‐based IVFE as part of an otherwise identical feeding protocol. Pulmonary artery pressure and urinary thromboxane B2 and prostaglandin F1 alpha were measured at baseline and maximum lipid infusion. Results: There was a greater fall in pulmonary artery pressure in the olive‐oil‐based IVFE group compared with the soy‐based IVFE group. A decrease in urine thromboxane/prostaglandin F1 alpha ratio was seen only in the olive‐oil‐based IVFE group. Conclusions: In the parenterally fed preterm infant, an olive‐oil‐based IVFE may have a beneficial effect on pulmonary artery pressure when compared with soy‐based IVFE. Effects on pulmonary vascular tone are likely to be mediated through alterations in eicosanoid metabolism. A randomized trial is warranted to compare the effects of different lipid emulsions.