Use of parenteral lipid emulsions in French neonatal ICUs.
OBJECTIVE
To determine the types of parenteral lipid emulsions currently used for preterm infants, their mode of delivery, and the main disease conditions that are considered by neonatologists as contraindications.


METHODS
National survey using a questionnaire.


METHODS
155 neonatal departments in France.


RESULTS
100 (65%) neonatal departments participated in the survey. The most widely used lipid emulsion was the 20% soybean oil/coconut oil-based emulsion (68% of the units), followed by the soybean oil-based emulsion (28.5%) and the soybean oil/olive oil-based emulsion (3.5%). Peripheral venous access was considered to be a possible route for the infusion of lipid emulsions in only 58 (63.7%) of the units. In 80%-90% of the units, sepsis, hemodynamic failure, thrombocytopenia, disseminated intravascular coagulation, and hyperbilirubinemia were considered to be relative or absolute contraindications, whereas only hemodynamic failure, disseminated intravascular coagulation, and to a lesser extent sepsis were most often perceived as absolute contraindications.


CONCLUSIONS
Neonatologists are somewhat reluctant to use parenteral lipids when only peripheral venous access is available, despite the low osmolarity of the emulsions. This may impair, at least temporarily, the adequate supply of energy and/or essential fatty acids in infants who do not have central venous access. This study also shows a large heterogeneity of responses with regard to the contraindications for parenteral lipids.
APHP, Department of Neonatology, Necker Hospital, 149 rue de Sèvre, 75015 Paris, France. alexandre.lapillonne@nck.aphp.fr
Alexandre
A
Lapillonne
Laure
L
Fellous
Elsa
E
Kermorvant-Duchemin
D000074263:Coconut Oil; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D005602:France; D017408:Guidelines as Topic; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D015931:Intensive Care, Neonatal / Q000379:methods; D000069463:Olive Oil; D010288:Parenteral Nutrition / Q000379:methods*; D010349:Patient Compliance; D010938:Plant Oils / Q000008:administration & dosage; D013024:Soybean Oil / Q000008:administration & dosage; D011795:Surveys and Questionnaires
D005217:Fat Emulsions, Intravenous; D000069463:Olive Oil; D010938:Plant Oils; D013024:Soybean Oil; D000074263:Coconut Oil