Olive oil-based intravenous lipid emulsion in pediatric patients undergoing bone marrow transplantation: a short-term prospective controlled trial.
OBJECTIVE
Parenteral nutrition (PN) is an important component of the supportive care of children undergoing bone marrow transplantation (BMT). The study aimed to assess short-term safety and metabolic effects of an olive oil-based (OO) lipid emulsion compared with a MCT/LCT (M/L) emulsion in the clinical setting of pediatric BMT.


METHODS
Twenty-eight pediatric BMT patients (age 1-18 years) expected to need PN support for at least 2 weeks, were prospectively enrolled and randomly assigned to receive either OO or M/L lipid emulsions within PN. Clinical and routine laboratory parameters, plasma fatty acids profile, vitamin E and peroxidation status were recorded at baseline and after 14 days of PN.


RESULTS
No significant differences were found for hematological parameters, liver enzymes, vitamins, plasma peroxidation status, percentage and time to engraftment. Taking into consideration the baseline fatty acids levels, the OO group showed higher oleic acid (p=0.012), linoleic (p=0.012) and arachidonic acid (p=0.002) enrichment but similar eicosapentanoic and docosahexanoic acids levels compared to the M/L group at day 14. Cholesterol levels decreased significantly in the OO group after 14 days on PN (p=0.017).


CONCLUSIONS
OO lipid emulsion was well tolerated, maintained essential fatty acids and peroxidation status, and generated a favorable plasma lipid profile. In this study short-term use of OO intravenous lipid emulsions was safe in children who needed PN support during BMT.
Hartman
Corina
C
Institute of Gastroenterology, Nutrition, and Liver Diseases, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. corinahartman@gmail.com
Ben-Artzi
Elisheva
E
Berkowitz
Drora
D
Elhasid
Ronit
R
Lajterer
Noah
N
Postovski
Serghei
S
Hadad
Salim
S
Shamir
Raanan
R
D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects* / Q000737:chemistry / Q000378:metabolism*; D006801:Humans; D007223:Infant; D015227:Lipid Peroxidation; D008055:Lipids / Q000097:blood; D008111:Liver Function Tests; D000069463:Olive Oil; D010288:Parenteral Nutrition / Q000379:methods*; D010938:Plant Oils / Q000008:administration & dosage*; D011446:Prospective Studies; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis; D014810:Vitamin E / Q000097:blood
D005217:Fat Emulsions, Intravenous; D008055:Lipids; D000069463:Olive Oil; D010938:Plant Oils; D017392:Thiobarbituric Acid Reactive Substances; D014810:Vitamin E