title: Normal Growth and Essential Fatty Acid Status in Children With Intestinal Failure on Lipid Limitation.
abstract: OBJECTIVE
  Lipid limitation, that is, ≤1 g · kg⁻¹ · day⁻¹ of soy oil lipid emulsion (SOLE), has been suggested as a method to reduce the risk of intestinal failure (IF)-associated liver disease (IFALD). There are limited data as to the effects of this strategy on growth and essential fatty acid (EFA) status. The aim of the study was to assess growth, prevalence of cholestasis, and EFA deficiency in patients with IF who were provided daily SOLE at a dose ≤1 g · kg⁻¹ · day⁻¹.
  
  
  METHODS
  Medical records were retrospectively reviewed from 9 patients age 16 months to 8 years who had IF requiring parenteral nutrition support for >12 months. Parenteral nutrition supplied a mean of 53% of total energy (range 24%-86%).
  
  
  RESULTS
  Mean SOLE dose was 0.61 g · kg⁻¹ · day⁻¹ (range 0.4-0.81 g · kg⁻¹ · day⁻¹). After 1 month of lipid limitation between 2011 and 2014, no patient developed IFALD as defined by a direct bilirubin >2 mg/dL. The median direct bilirubin was 0.1 mg/dL (range 0.075-0.85 mg/dL). No patient developed EFA deficiency as defined by a triene-to-tetraene ratio >0.2 (median 0.026, range 0.017-0.076). Height z scores increased from mean of -2.568 (range -10.8 to 0.878) to -0.484 (range -3.546 to 0.822). Weight z scores increased from mean of -1.412 (range -5.871 to 0.906) to -0.595 (range -2.178 to 0.926).
  
  
  CONCLUSIONS
  In this case series, lipid limitation allowed normal growth while preventing the development of cholestasis and EFA deficiency.
authors: Division of Pediatric Gastroenterology, Children's Hospital at Montefiore, Bronx, NY.
authors: Gillian
authors: G
authors: Lam
authors: Irina G
authors: IG
authors: Strogach
authors: Nicole
authors: N
authors: Baron
authors: John F
authors: JF
authors: Thompson
mesh_terms: D001663:Bilirubin / Q000097:blood; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D002779:Cholestasis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003677:Deficiency Diseases / Q000517:prevention & control*; D005217:Fat Emulsions, Intravenous / Q000737:chemistry; D005228:Fatty Acids, Essential / Q000097:blood* / Q000172:deficiency; D005260:Female; D006128:Growth; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000150:complications* / Q000628:therapy; D007422:Intestines / Q000473:pathology; D008055:Lipids / Q000008:administration & dosage; D008099:Liver / Q000187:drug effects / Q000473:pathology; D017093:Liver Failure / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D008297:Male; D010288:Parenteral Nutrition / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D013024:Soybean Oil / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D005217:Fat Emulsions, Intravenous; D005228:Fatty Acids, Essential; D008055:Lipids; D013024:Soybean Oil; D001663:Bilirubin