title: The effect of parenteral lipid emulsions on pulmonary hemodynamics and eicosanoid metabolites in preterm infants: a pilot study.
abstract: BACKGROUND
  Soy-based intravenous fat emulsion (IVFE) is known to cause a rise in pulmonary artery pressure in the preterm infant, thought to be mediated through eicosanoid metabolites of linoleic acid. We compared the effect of soy-based IVFE and an olive-oil-based IVFE containing less than half the content of linoleic acid on pulmonary artery pressure and eicosanoid metabolites in preterm infants receiving parenteral nutrition.
  
  
  METHODS
  In this pilot study at a regional neonatal intensive care unit (ICU), infants received either a soy-based or olive-oil-based IVFE as part of an otherwise identical feeding protocol. Pulmonary artery pressure and urinary thromboxane B2 and prostaglandin F1 alpha were measured at baseline and maximum lipid infusion.
  
  
  RESULTS
  There was a greater fall in pulmonary artery pressure in the olive-oil-based IVFE group compared with the soy-based IVFE group. A decrease in urine thromboxane/prostaglandin F1 alpha ratio was seen only in the olive-oil-based IVFE group.
  
  
  CONCLUSIONS
  In the parenterally fed preterm infant, an olive-oil-based IVFE may have a beneficial effect on pulmonary artery pressure when compared with soy-based IVFE. Effects on pulmonary vascular tone are likely to be mediated through alterations in eicosanoid metabolism. A randomized trial is warranted to compare the effects of different lipid emulsions.
authors.affiliation: Chakrapani Vasudevan, MRCPCH, DCH, DNB, University Department of Paediatrics, Floor D, Clarendon Wing, Leeds General Infirmary, Leeds LS2 9NS, UK. Email: C. Vasudevan@leeds.ac.uk.
authors.forename: Chakrapani
authors.initials: C
authors.lastname: Vasudevan
authors.forename: Kathryn
authors.initials: K
authors.lastname: Johnson
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Miall
authors.forename: Douglas
authors.initials: D
authors.lastname: Thompson
authors.forename: John
authors.initials: J
authors.lastname: Puntis
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D004041:Dietary Fats / Q000494:pharmacology*; D015777:Eicosanoids / Q000652:urine*; D005217:Fat Emulsions, Intravenous / Q000494:pharmacology*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D019787:Linoleic Acid / Q000494:pharmacology; D031658:Olea / Q000737:chemistry; D000069463:Olive Oil; D010288:Parenteral Nutrition; D010865:Pilot Projects; D010938:Plant Oils / Q000737:chemistry / Q000494:pharmacology*; D011460:Prostaglandins F / Q000097:blood; D011651:Pulmonary Artery / Q000187:drug effects* / Q000502:physiology; D013024:Soybean Oil / Q000737:chemistry / Q000494:pharmacology; D013025:Glycine max / Q000737:chemistry; D013929:Thromboxane B2 / Q000652:urine
chemical_list: D004041:Dietary Fats; D015777:Eicosanoids; D005217:Fat Emulsions, Intravenous; D000069463:Olive Oil; D010938:Plant Oils; D011460:Prostaglandins F; D013929:Thromboxane B2; D013024:Soybean Oil; D019787:Linoleic Acid; C100006:prostaglandin F1
keywords: intravenous fat emulsions; lung diseases; parenteral nutrition; premature infant