You will be required to have some blood tests performed and sign a Consent Form prior to the infusion. Intralipid is given as an intravenous infusion. Studies have found that Intralipid can help regulate the NK cells, allowing the embryo to implant on the uterine wall and grow normally. In women who have autoimmune issues, the NK cells can react abnormally to an implanting embryo, treating it has an invading cell and signalling for the body to attack it. Natural Killer (NK) cells are regulated by the immune system. Research in both animals and humans has shown that Intralipid may enhance implantation and maintenance of pregnancy. Further research is needed to delineate the impact of Smoflipid use for long-term PN on medically complex neonates.Intralipid is a fat emulsion solution that consists of soybean oil, egg yolk phospholipids and glycerine. However, a higher severity of cholestasis was observed in the Smoflipid group even after PS matching. Conclusion: Our study suggests that lipid emulsion type does not have a statistically significant effect on the incidence of PNAC, but Smoflipid may clinically enhance growth, shorten the length of NICU hospitalization, and reduce mortality before discharge. Time to developing cholestasis was clinically shorter in the Smoflipid group with higher peak direct bilirubin levels was longer in the Smoflipid group with statistical significance, but they had clinically shorter NICU stays and a reduction in mortality before discharge (Table 2). There was also a decreased incidence of PNAC in the Smoflipid group compared to the Intralipid group (Table 2). In the PS matching analysis, the Smoflipid group gained more weight clinically from birth to 8-9 weeks (Table 2). Results: The Smoflipid group had a 37% lower odds of developing PNAC, but lipid-type did not have a significant effect on PNAC with regression analysis (OR, 0.73 CI, 0.27-1.95 p=.52) (Table 1). Demographic characteristics and outcomes were compared between Intralipid and Smoflipid groups using Mann-Whitney U and chi-square test as appropriate before and after the PS matching. We utilized a 2:1 propensity score (PS) match resulting in 44 Intralipid and 22 Smoflipid babies included in the secondary analysis. The independent association of lipid emulsion type with PNAC among the total sample (N=138) was analyzed using an overlap propensity score weighted logistic regression model.
In order to achieve comparability of treatment groups, a propensity score was built using the following variables: sex, gestational age, birth weight, intubation at birth, gastrointestinal operation in the NICU, gastroschisis, necrotizing enterocolitis, intestinal atresia, culture-positive sepsis, and bowel perforation. Methods: A single-center retrospective cohort study was conducted with 138 neonates admitted to a Level IV NICU between January 1st, 2013 and December 31st, 2020, who required PN for ≥4 weeks with Smoflipid 20% (N=37) or Intralipid 20% (N=101). The aim of this study was to determine the association of PNAC with mixed-oil (Smoflipid) versus soybean-oil (Intralipid) lipid emulsion use in high-risk neonates on prolonged PN and the impact on clinical outcomes.
Background: Many neonatal intensive care units (NICU) have transitioned from conventional soy-based to mixed-oil lipid emulsions, but the literature examining the impact on the incidence and severity of parenteral nutrition-associated cholestasis (PNAC) in high-risk neonates on long-term parenteral nutrition (PN) is limited.
0 kommentar(er)
