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High Early Parenteral Lipid in Very Preterm Infants: A Randomized-Controlled Trial.

Authors
  • Alburaki, Wissam1
  • Yusuf, Kamran2
  • Dobry, Jenna2
  • Sheinfeld, Rachel2
  • Alshaikh, Belal3
  • 1 Neonatal Nutritional and Gastroenterology Program, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada. , (Canada)
  • 2 Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada. , (Canada)
  • 3 Neonatal Nutritional and Gastroenterology Program, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada. Electronic address: [email protected] , (Canada)
Type
Published Article
Journal
The Journal of pediatrics
Publication Date
Aug 13, 2020
Identifiers
DOI: 10.1016/j.jpeds.2020.08.024
PMID: 32798567
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To determine whether high early parenteral soybean oil lipid intake in very low birth weight (VLBW) infants in the first week after birth decreases the proportion of weight loss and subsequently the incidence of extrauterine growth restriction (EUGR). This was a randomized controlled trial of appropriate for gestational- ge VLBW infants. Lipid intake in the control group started at 0.5-1 g/kg per day and increased daily by 0.5-1 g/kg per day till reaching 3 g/kg per day. The intervention group was started on 2 g/kg per day that increased to 3 g/kg per day the following day. Of the 176 infants assessed for eligibility, 83 were included in the trial. Infants in the intervention group were started on lipid sooner (13.8 ± 7.8 vs 17.5 ± 7.8 hour; P = .03) and had higher cumulative lipid intake in the first 7 days of age (13.5 ± 4.2 vs 10.9 ± 3.5 g/kg per day; P = .03). Infants in the intervention group had a lower percentage of weight loss (10.4 vs 12.7%; P = .02). The mean triglyceride level was higher in the intervention group (1.91 ± 0.79 vs 1.49 ± 0.54 mmol/L; P = .01), however, hypertriglyceridemia was similar between the 2 groups. The incidence of EUGR was lower in the intervention group (38.6% vs 67.6%; P = .01). Head circumference z score was higher in the intervention group (-1.09 ± 0.96 vs -1.59 ± 0.98; P = .04). In VLBW infants, provision of a high early dose of parenteral lipid in the first week of age results in less weight loss and lower incidence of EUGR. Clinicaltrials.gov: NCT03594474. Copyright © 2020 Elsevier Inc. All rights reserved.

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