The following is a summary of “Intestinal Failure-Associated Liver Disease and Growth Pre- and Post-Transition to a Composite Lipid Emulsion,” published in the June 2023 issue of Pediatrics by Hudson, et al.
For a study, researchers sought to compare the rates of intestinal failure-associated liver disease (IFALD) and growth outcomes in infants with intestinal failure who received a composite intravenous lipid emulsion (ILE) versus soybean oil ILE.
A retrospective analysis was conducted at two tertiary neonatal/pediatric hospitals. Infants aged ≤1 year who received parenteral nutrition (PN) for ≥6 weeks between 2010 and 2018 were included. Data on liver parameters and growth were collected. IFALD was defined as serum conjugated bilirubin (CB) levels >33 µmol/L (≥2 mg/dL). Nonparametric tests were used for comparisons.
The study included 50 infants, 35 receiving composite ILE and 15 receiving soybean oil ILE. Infants on composite ILE had a longer duration of PN (10.1 vs. 7.6 weeks; P = 0.001) and higher baseline CB levels (29 vs. 6.5 μmol/L; P = 0.001). However, no significant differences were observed at 6 weeks (14.5 vs. 5 μmol/L; P = 0.54) or PN cessation (4 vs. 4 μmol/L; P = 0.33). The proportion of patients with IFALD decreased from 54% to 20% in the composite ILE group while remaining stable in the soybean oil ILE group (7%). There were no significant differences in weight, length, or head circumference z scores between the two groups (P > 0.05).
In the study, composite ILE was associated with decreased rates of IFALD in infants with intestinal failure, despite a longer duration of PN and higher baseline CB levels. Regardless of the type of parenteral lipid used, there were no differences in growth outcomes.