Influence of different intravenous lipid emulsions on hepatobiliary dysfunction in a rabbit model.
OBJECTIVE
Long-term total parenteral nutrition (TPN) in children is often complicated by the development of cholestasis, liver fibrosis, and liver failure. High doses of intravenous lipids may be involved in the pathogenesis of hepatobiliary dysfunction. The purpose of this study was to determine whether the use of 2 newly developed lipid emulsions could reduce liver damage.


METHODS
Three groups of prepubescent rabbits received TPN including a lipid emulsion either based on soybean oil, olive oil, or soybean oil with n-3 fatty acids added. Enterally fed animals served as controls. After 21 d the animals were killed. Serum samples were obtained at the beginning and end of the study period. Specimens were processed for histological evaluation using a specific score to assess the severity of liver damage.


RESULTS
Biochemical parameters did not predict the extent of liver damage. Hydropic degeneration as an indicator of toxic liver injury was the predominant histological alteration regardless of the type of lipids infused. The extent of fibrosis did not significantly differ among treatment groups except for animals infused with n-3 fatty acids exhibiting increased fibrotic transformation as compared with controls.


CONCLUSIONS
In our animal model, the use of a lipid emulsion with a reduced amount of polyunsaturated fatty acids was not superior to a lipid emulsion based on soybean oil. Long-term application of n-3 fatty acids was associated with more extensive fibrosis. Therefore, intravenous n-3 fatty acids containing lipid preparations (fish oil) should not be used in patients for long-term TPN.
Kohl
Martina
M
Department of Pediatrics, University Hospital, Luebeck, Germany.
Wedel
Thilo
T
Entenmann
Andreas
A
Stuttmann
Julia
J
Bendiks
Meike
M
Loff
Steffan
S
Köster
Stefan
S
Ortfeld
Stefan
S
Bos
Inge
I
D000818:Animals; D001659:Biliary Tract / Q000187:drug effects*; D004195:Disease Models, Animal; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects / Q000494:pharmacology*; D022781:Hepatocytes / Q000187:drug effects; D008099:Liver / Q000187:drug effects*; D008103:Liver Cirrhosis / Q000139:chemically induced; D008297:Male; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D011817:Rabbits
D005217:Fat Emulsions, Intravenous