title: Parenteral lipid administration to very-low-birth-weight infants--early introduction of lipids and use of new lipid emulsions: a systematic review and meta-analysis.
abstract: BACKGROUND
  The use of intravenous lipid emulsions in preterm infants has been limited by concerns regarding impaired lipid tolerance. As a result, the time of initiation of parenteral lipid infusion to very-low-birth-weight (VLBW) infants varies widely among different neonatal intensive care units. However, lipids provide energy for protein synthesis and supply essential fatty acids that are necessary for central nervous system development.
  
  
  OBJECTIVE
  The objective was to summarize the effects of initiation of lipids within the first 2 d of life and the effects of different lipid compositions on growth and morbidities in VLBW infants.
  
  
  METHODS
  A systematic review and meta-analysis of publications identified in a search of PubMed, EMBASE, and Cochrane databases was undertaken. Randomized controlled studies were eligible if information on growth was available.
  
  
  RESULTS
  The search yielded 14 studies. No differences were observed in growth or morbidity with early lipid initiation. We found a weak favorable association of non-purely soybean-based emulsions with the incidence of sepsis (RR: 0.75; 95% CI: 0.56, 1.00).
  
  
  CONCLUSIONS
  The initiation of lipids within the first 2 d of life in VLBW infants appears to be safe and well tolerated; however, beneficial effects on growth could not be shown for this treatment nor for the type of lipid emulsion. Emulsions that are not purely soybean oil-based might be associated with a lower incidence of sepsis. Large-scale randomized controlled trials in preterm infants are warranted to determine whether early initiation of lipids and lipid emulsions that are not purely soybean oil-based results in improved long-term outcomes.
authors: Division of Neonatology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands.
authors: Hester
authors: H
authors: Vlaardingerbroek
authors: Margriet A B
authors: MA
authors: Veldhorst
authors: Sandra
authors: S
authors: Spronk
authors: Chris H P
authors: CH
authors: van den Akker
authors: Johannes B
authors: JB
authors: van Goudoever
mesh_terms: D003625:Data Collection; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D007363:Intensive Care Units, Neonatal; D008055:Lipids / Q000627:therapeutic use*; D010288:Parenteral Nutrition / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D013024:Soybean Oil / Q000627:therapeutic use
chemical_list: D005217:Fat Emulsions, Intravenous; D008055:Lipids; D013024:Soybean Oil