title: Fish Oil (SMOFlipid) and olive oil lipid (Clinoleic) in very preterm neonates.
abstract: OBJECTIVE
  Fat emulsions used in Australia for parenteral nutrition in preterm neonates have been based on either soybean oil or olive oil (OO). OO lipid Clinoleic has a high ratio of n-6 to n-3 fatty acids (9:1); this may not be ideal for long-chain polyunsaturated fatty acids supply. Newly available SMOFlipid has an appropriate ratio of n-6 to n-3 fatty acids (2.5:1). SMOFlipid also contains OO (25%), coconut oil (30%), and soybean oil (30%). The aims of the study were to evaluate the safety of the SMOFlipid and to test the hypothesis that SMOFlipid would lead to increased omega-3 long-chain polyunsaturated fatty acid levels and reduced oxidative stress as compared with Clinoleic in preterm neonates (<30 weeks).
  
  
  METHODS
  Preterm neonates (23-30 weeks) were randomised to receive Clinoleic or SMOFlipid emulsion for 7 days. Investigators and outcome assessors were masked to allocation. Plasma F2-isoprostanes (lipid peroxidation marker), red blood cell fatty acids, and vitamin E were measured before and after the study. Blood culture positive sepsis and growth were monitored for safety.
  
  
  RESULTS
  Thirty of 34 participants completed the study. Both emulsions were well tolerated without any adverse events. F2-isoprostane levels were reduced in the SMOFlipid group as compared with baseline. Eicosapentanoic acid and vitamin E levels were significantly increased in the SMOFlipid group. Oleic acid and linoleic acid levels were increased in both groups. No significant differences were noted in poststudy docosahexaenoic acid levels in both groups despite higher levels of docosahexaenoic acid in SMOFlipid.
  
  
  CONCLUSIONS
  SMOFlipid was safe, well tolerated, and showed beneficial effect in terms of reduction of oxidative stress by reducing lipid peroxidation levels in high-risk preterm neonates.
authors.affiliation: *Department of Neonatal Paediatrics, King Edward Memorial Hospital Western Australia †School of Medicine and Pharmacology, University of Western Australia ‡Department of Pharmacy, King Edward Memorial Hospital for Women, Perth, Australia.
authors.forename: Girish
authors.initials: G
authors.lastname: Deshpande
authors.forename: Karen
authors.initials: K
authors.lastname: Simmer
authors.forename: Mangesh
authors.initials: M
authors.lastname: Deshmukh
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Mori
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Croft
authors.forename: Judy
authors.initials: J
authors.lastname: Kristensen
mesh_terms: D000074263:Coconut Oil; D004281:Docosahexaenoic Acids / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood; D028441:F2-Isoprostanes / Q000097:blood; D005217:Fat Emulsions, Intravenous / Q000737:chemistry / Q000494:pharmacology*; D005231:Fatty Acids, Unsaturated / Q000097:blood / Q000494:pharmacology*; D005260:Female; D005395:Fish Oils / Q000494:pharmacology*; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D019787:Linoleic Acid / Q000097:blood; D015227:Lipid Peroxidation / Q000187:drug effects; D008297:Male; D019301:Oleic Acid / Q000097:blood; D000069463:Olive Oil; D018384:Oxidative Stress / Q000187:drug effects*; D010289:Parenteral Nutrition, Total; D010938:Plant Oils / Q000494:pharmacology*; D013024:Soybean Oil / Q000097:blood / Q000494:pharmacology*; D014810:Vitamin E / Q000097:blood
chemical_list: C568346:ClinOleic; D028441:F2-Isoprostanes; D005217:Fat Emulsions, Intravenous; D005231:Fatty Acids, Unsaturated; D005395:Fish Oils; D000069463:Olive Oil; D010938:Plant Oils; D014810:Vitamin E; D004281:Docosahexaenoic Acids; D019301:Oleic Acid; D013024:Soybean Oil; D019787:Linoleic Acid; D015118:Eicosapentaenoic Acid; D000074263:Coconut Oil