The effect of 5 intravenous lipid emulsions on plasma phytosterols in preterm infants receiving parenteral nutrition: a randomized clinical trial.

Study answer

What this study found

Lower-phytosterol emulsions reduced plasma phytosterol exposure, but this did not improve liver outcomes. Plasma phytosterol concentrations were highest in the S group and lowest in the MOSF group on PN days 7 and 14, and the MSF group had significantly lower beta-sitosterol than the MS group. Cumulative phytosterol intake correlated positively with plasma phytosterol concentrations. Cholestasis was rare (3 patients, 2.1%: 1 each in MS, MSF, and MOSF; none in S or OS), and liver function at 6 weeks did not differ across groups; neither phytosterol intake nor plasma phytosterol levels were…

Study & population

Randomized clinical trial in very low birth weight preterm infants in the NICU who received parenteral nutrition from birth.

Intervention

Five intravenous lipid emulsions were compared in preterm infants receiving parenteral nutrition for 21 days: S, 100% soybean oil, 1 g/kg/day; MS, 50% medium-chain triglycerides and 50% soybean oil, 1.5 g/kg/day; MSF, 50% medium-chain triglycerides, 40% soybean oil, and 10% fish oil, 2 g/kg/day; OS, 80% olive oil and…

Key limitation

The trial was relatively small within each arm, with only 27 to 30 infants per group, and the clinical outcome of cholestasis was very rare, limiting power to detect differences in liver disease.

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Original abstract