https://pubmed.ncbi.nlm.nih.gov/34695449/

J Pediatr. 2021 Oct 22;S0022-3476(21)01023-4.
doi: 10.1016/j.jpeds.2021.10.030.Online ahead of print.

Use of Intravenous Soybean and Fish Oil Emulsions in Pediatric Intestinal Failure Associated Liver Disease: A Multicenter Integrated Analysis Report on Extrahepatic Adverse Events

Kathleen M Gura 1, Kara L Calkins 2, Muralidhar H Premkumar 3, Mark Puder 4

Abstract

Objective: To compare extrahepatic adverse events (AEs) during fish oil lipid emulsion (FOLE) or soybean oil lipid emulsion (SOLE) treatment in children with intestinal failure-associated liver disease (IFALD).
Study design: In this multicenter integrated analysis, bleeding, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), infections, and signs of lipid emulsion intolerance were compared between FOLE recipients (1 g/kg/d) (n = 189) and historical controls who received SOLE (up to 3 g/kg/d) (n = 73).

Results: When compared with SOLE recipients, FOLE recipients had a lower gestational age (30.5 vs 33 weeks, P = 0.0350) and higher baseline direct bilirubin (DB) (5.8 vs 3.0 mg/dL, P < 0.0001). FOLE recipients had a decreased incidence of bleeding (P < 0.0001), BPD (P < 0.001), ROP (P < 0.0156), bacterial and fungal infections (P < 0.0001), and lipid intolerance signs (P < 0.02 for all). Subjects with bleeding vs. subjects without bleeding had higher baseline DB; the odds ratios for baseline DB (by mg/dL) and treatment (FOLE vs SOLE) were 1.20 (95% CI: 1.10, 1.31, P ≤ 0.0001) and 0.22 (95% CI: 0.11, 0.46, P ≤ 0.0001), respectively. In preterm subjects, a higher BPD (P < 0.0001) and ROP incidence (P = 0.0071) was observed in SOLE recipients vs. FOLE recipients.

Conclusion: Children with IFALD who received FOLE had fewer extrahepatic AEs including a decreased incidence of bleeding, preterm co-morbidities, and lipid intolerance signs compared with children with IFALD who received SOLE.