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Prevention and reversal of intestinal failure-associated liver disease in premature infants with short bowel syndrome using intravenous fish oil in combination with omega-6/9 lipid emulsions
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
2011 (English)In: Journal of Pediatric Surgery, ISSN 0022-3468, E-ISSN 1531-5037, Vol. 46, no 7, p. 1361-1367Article in journal (Refereed) Published
Abstract [en]

Although premature infants with short bowel syndrome are at the highest risk of developing intestinal failure-associated liver disease (IFALD), they have great capacity for intestinal growth and adaptation if IFALD can be prevented. Conventional soybean oil-based intravenous lipid emulsions have been associated with IFALD. This study presents data on 5 premature neonates with short bowel syndrome treated with a combination of parenteral fish oil-and olive/soybean-based lipid emulsion for periods ranging between 7 and 17 months. Despite an enteral tolerance of less than 50% in 4 of these patients during their first year of life, direct bilirubin levels normalized while on this combination of ClinOleic (Baxter, Maurepas, France)/Omegaven (Fresenius Kabi, Bad Homburg, Germany) at a 1: 1 ratio. None of our patients developed irreversible IFALD even though all of them were premature, had undergone multiple major surgical procedures, and had experienced several episodes of sepsis. Thus far, we have not seen any adverse effects of this mixed lipid emulsion in these preterm infants. All 5 patients are growing and developing well and have normal liver function.

Place, publisher, year, edition, pages
2011. Vol. 46, no 7, p. 1361-1367
Keyword [en]
Short bowel syndrome, Intestinal failure-associated liver disease (IFALD), Fish oil-based lipid emulsion, Omega-6/9 lipid emulsion
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-156965DOI: 10.1016/j.jpedsurg.2010.12.021ISI: 000292882000018OAI: oai:DiVA.org:uu-156965DiVA: diva2:435813
Available from: 2011-08-20 Created: 2011-08-11 Last updated: 2017-12-08Bibliographically approved

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Paulsson, Mattias

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