title: Lipid emulsions in the treatment and prevention of parenteral nutrition-associated liver disease in infants and children.
abstract: Long-term parenteral nutrition (PN) carries the risk of progressive liver disease in infants with intestinal failure. Although PN-associated liver disease (PNALD) is multifactorial in etiology, components of soybean oil lipid emulsions have been implicated in the disease's pathogenesis. Historically, infants with PNALD who were unable to wean from PN to full enteral feeding developed cirrhosis and end-stage liver disease, which require liver transplantation to survive. Over the past 2 decades, novel strategies for the management of parenteral lipids have improved morbidity and mortality from PNALD in infants with intestinal failure. Current strategies for the treatment of PNALD include restricting the dose of parenteral soybean oil lipid emulsion and/or replacing the soybean oil with a parenteral fish-oil lipid emulsion or emulsions of mixed-lipid sources. The purpose of this report is to review published data that evaluate these strategies in parenteral lipid management for the treatment and prevention of PNALD.
authors.affiliation: Vascular Biology Program and Department of Surgery and.
authors.forename: Prathima
authors.initials: P
authors.lastname: Nandivada
authors.affiliation: Vascular Biology Program and Department of Surgery and.
authors.forename: Gillian L
authors.initials: GL
authors.lastname: Fell
authors.affiliation: Department of Pharmacy, Boston Children's Hospital, Boston, MA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Gura
authors.affiliation: Vascular Biology Program and Department of Surgery and mark.puder@childrens.harvard.edu.
authors.forename: Mark
authors.initials: M
authors.lastname: Puder
mesh_terms: D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000639:trends; D019317:Evidence-Based Medicine; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D005395:Fish Oils / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D048550:Hepatic Insufficiency / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010288:Parenteral Nutrition / Q000009:adverse effects* / Q000639:trends; D057285:Precision Medicine; D047928:Premature Birth / Q000503:physiopathology / Q000628:therapy; D013024:Soybean Oil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D013024:Soybean Oil
keywords: PNALD; fish oil; intestinal failure; lipid emulsions; liver disease; parenteral lipids; soybean oil