Exclusive Fish Oil Lipid Emulsion Rescue Strategy Improves Cholestasis in Neonates on Partially Fish Oil-Based Lipid Emulsion: A Pilot Study

Article Pediatrics

Neurodevelopmental Outcome of Extremely Low Birth Weight Infants with Cholestasis at 12 and 24 Months

Margarita Thanhaeuser et al.

Summary: This study aimed to describe the neurodevelopmental outcome of extremely low birth weight (ELBW) infants with parenteral nutrition-associated cholestasis (PNAC) and found that ELBW infants with PNAC have delayed neurodevelopment and are at increased risk for adverse motor outcome.

NEONATOLOGY (2022)

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Review Pharmacology & Pharmacy

Current strategies for managing intestinal failure-associated liver disease

Jordan D. Secor et al.

Summary: IFALD is a hepatic dysfunction caused by prolonged use of PN, and its treatment and management require a multifactorial approach. Prompt recognition of high-risk patients, avoiding excessive intake of nutrients, and preventing central line-associated bloodstream infections are key to improving outcomes. Fish oil monotherapy seems to be effective, but the most effective intervention remains discontinuation of PN and achieving full enteral feedings.

EXPERT OPINION ON DRUG SAFETY (2021)

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Review Nutrition & Dietetics

Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates

Gregory Guthrie et al.

Summary: Total parenteral nutrition (TPN) is a critical intervention for infants unable to feed orally, but prolonged reliance on TPN poses a risk of liver injury, particularly through parenteral nutrition associated cholestasis (PNAC) driven by lipid emulsions. Studies suggest that new emulsions containing fish oil and medium chain triglycerides show promise in reducing the incidence of PNAC.

NUTRIENTS (2021)

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Review Nutrition & Dietetics

Intravenous Lipid Emulsions in the Prevention and Treatment of Liver Disease in Intestinal Failure

Fedja A. Rochling

Summary: The development of IFALD in pediatric and adult patients on parenteral nutrition is multifactorial, with nutritional and non-nutritional causes. Lipid therapy plays a significant role in contributing to IFALD, and the pathophysiological pathways are now better understood. The introduction of fish oil-based lipid emulsions has shown success in resolving IFALD associated with soybean oil-based therapy, with evidence supporting early switch to fish oil-based therapy to successfully halt and reverse IFALD.

NUTRIENTS (2021)

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Review Biochemistry & Molecular Biology

Specialized Pro-Resolving Lipid Mediators in Neonatal Cardiovascular Physiology and Diseases

Andrea Gila-Diaz et al.

Summary: Specialized Pro-Resolving Mediators (SPMs) derived from long chain polyunsaturated fatty acids (LCPUFAs) play a critical role in cardiovascular health and disease, particularly in neonates. These mediators enhance host defense by resolving inflammation and promoting tissue repair, and also possess anti-inflammatory properties.

ANTIOXIDANTS (2021)

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Article Pediatrics