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The effects of two mixed intravenous lipid emulsions on clinical outcomes in infants after gastrointestinal surgery: a prospective, randomized study

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Abstract

Background

There are many advantages of a SMOF emulsion (SMOF-lipid), such as liver-protective properties and anti-inflammatory effects. The objective of this study was to compare the clinical outcomes of SMOF-lipid with medium-chain triglycerides (MCT) /long-chain triglycerides (LCT) in infants after intestinal surgery.

Methods

This was a prospective, randomized study. Neonates receiving intravenous nutrient solution, including lipid emulsion after gastrointestinal surgery, were included in this study. The patients were randomly assigned to the SMOF-lipid or MCT/LCT groups. Infants who received intravenous lipid emulsion continuously for > 2 weeks were considered to have completed the study. Differences in weight gain, nutrition indices, alanine transaminase (ALT), aspartate transaminase (AST), and direct bilirubin (DB), and inflammation cytokine markers (interleukin [IL]-6 and tumor necrosis factor [TNF]-α) were measured.

Results

The final sample included 160 infants. One hundred fourteen infants received intravenous SMOF-lipid (74) or MCT/LCT (86) > 2 weeks and 46 infants received intravenous SMOF-lipid (22) or MCT/LCT (24) > 4 weeks. There were no significant differences in weight gain, nutrition indices, inflammation cytokine markers, and sepsis between the groups at the end of 2 and 4 weeks; however, in the SMOF group, the ALT, AST, and DB levels were significantly lower than the MCT/LCT group at the end of 4 weeks.

Conclusion

The mixture and balanced emulsion of SMOF-lipid was well-tolerated in infants who have undergone gastrointestinal surgery, and liver-protective properties were demonstrated following long-term venous nutrition, especially > 4 weeks.

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Acknowledgements

This study was supported by the National Natural Science Foundation of China (81100318), the Jiangsu Provincial key research and development program (BE2017609), Jiangsu youth medical talent project (QNRC2016081), and Children’s Hospital of Nanjing Medical University youth medical talent project (ETYYQM2014009), Nanjing Science and Technology Project (201823015).

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Authors and Affiliations

  1. Department of Neonatal Surgery, Children’s Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China

    Weiwei Jiang, GuangLin Chen, Jie Zhang, Xiaofeng Lv, Changgui Lu, Huan Chen, Wei Li, Hongxing Li, Qiming Geng, Xiaoqun Xu & Weibing Tang

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  1. Weiwei Jiang
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  2. GuangLin Chen
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Correspondence to Weibing Tang.

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Jiang, W., Chen, G., Zhang, J. et al. The effects of two mixed intravenous lipid emulsions on clinical outcomes in infants after gastrointestinal surgery: a prospective, randomized study. Pediatr Surg Int 35, 347–355 (2019). https://doi.org/10.1007/s00383-018-4422-2

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