title: Short-term use of parenteral nutrition with a lipid emulsion containing a mixture of soybean oil, olive oil, medium-chain triglycerides, and fish oil: a randomized double-blind study in preterm infants.
abstract: BACKGROUND
  For premature neonates needing parenteral nutrition (PN), a balanced lipid supply is crucial. The authors hypothesized that a lipid emulsion containing medium-chain triglycerides (MCTs) and soybean, olive, and fish oils would be as safe and well tolerated as a soybean emulsion while beneficially influencing the fatty acid profile.
  
  
  METHODS
  Double-blind, controlled study in 53 neonates (<34 weeks' gestation) randomized to receive at least 7 days of PN containing either an emulsion of MCTs and soybean, olive, and fish oils or a soybean oil emulsion. Target lipid dosage was 1.0 g fat/kg body weight [BW]/d on days 1-3, 2 g/kg BW/d on day 4, 3 g/kg BW/d on day 5, and 3.5 g/kg BW/d on days 6-14.
  
  
  RESULTS
  Test emulsion vs control, mean ± SD: baseline triglyceride concentrations were 0.52 ± 0.16 vs 0.54 ± 0.19 mmol/L and increased similarly in both groups to 0.69 ± 0.38 vs 0.67 ± 0.36 on day 8 of treatment (P = .781 for change). A significantly higher decrease in total and direct bilirubin vs baseline was seen in the test group compared with the control group P < .05 between groups). In plasma and red blood cell phospholipids, eicosapentaenoic acid and docosahexaenoic acid were higher, and the n-6/n-3 fatty acid ratio was lower in the test group (P < .05 vs control).
  
  
  CONCLUSIONS
  The lipid emulsion, based on a mixture of MCTs and soybean, olive, and fish oils, was safe and well tolerated by preterm infants while beneficially modulating the fatty acid profile.
authors.affiliation: Department of Neonatology, University Hospitals, Leuven, Belgium. maissa.rayyan@uzleuven.be
authors.forename: Maissa
authors.initials: M
authors.lastname: Rayyan
authors.forename: Hugo
authors.initials: H
authors.lastname: Devlieger
authors.forename: Frank
authors.initials: F
authors.lastname: Jochum
authors.forename: Karel
authors.initials: K
authors.lastname: Allegaert
mesh_terms: D004311:Double-Blind Method; D004655:Emulsions; D004912:Erythrocytes / Q000737:chemistry; D005227:Fatty Acids / Q000097:blood; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008099:Liver / Q000378:metabolism; D008297:Male; D000069463:Olive Oil; D010288:Parenteral Nutrition / Q000379:methods*; D010743:Phospholipids / Q000097:blood; D010938:Plant Oils / Q000008:administration & dosage*; D016016:Proportional Hazards Models; D013024:Soybean Oil / Q000008:administration & dosage*; D016896:Treatment Outcome; D014280:Triglycerides / Q000008:administration & dosage* / Q000097:blood
chemical_list: D004655:Emulsions; D005227:Fatty Acids; D005395:Fish Oils; D000069463:Olive Oil; D010743:Phospholipids; D010938:Plant Oils; D014280:Triglycerides; D013024:Soybean Oil