title: Effects of Soybean Lipid Infusion on Unbound Free Fatty Acids and Unbound Bilirubin in Preterm Infants.
abstract: To assess the effects of a soybean lipid emulsion infusions on levels of unbound (free) bilirubin (Bf) and unbound free fatty acids (FFAu) as well as changes in Bf and total serum bilirubin (TSB) during phototherapy in infants born preterm.
  
  
  
  Ninety-seven infants born preterm (birth weight: 500-2000 g; gestational age: 23-34 weeks) were enrolled to investigate the effect of 0, 1, 2, and 3 g/kg/d of intralipid infusion on Bf and FFAu. Pre- and postphototherapy TSB, FFAu, and Bf also were analyzed in 91 infants to assess the effects of phototherapy. FFAu levels were measured with the fluorescent probe ADIFAB2 and Bf by the fluorescent Bf sensor BL22P1B11-Rh during intralipid infusion and at start and end of phototherapy. TSB and plasma albumin were measured by the diazo and bromcresol green techniques, respectively. Bilirubin-albumin dissociation constants were calculated based on Bf and plasma albumin.
  
  
  
  Bf and FFAu increased with increasing intralipid dosage across all gestational ages. TSB and Bf were correlated significantly when infants received 0 or 1 g/kg/d of intralipid but not at greater doses of intralipid (2 and 3 g/kg/d). Although phototherapy effectively reduced both TSB and Bf in the total phototherapy group (by 32% and 12%, respectively), it reduced TSB, but not Bf, in infants less than 28 weeks of gestation.
  
  
  
  Increasing intralipid doses result in increasing FFAu levels, which are associated with increased Bf independent of TSB. In infants born extremely preterm (<28 weeks of gestation), phototherapy effectively reduces TSB but not Bf.
authors.affiliation: Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers, The State University of NJ, New Brunswick, NJ.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hegyi
authors.affiliation: Fluoresprobe Sciences, San Diego, CA.
authors.forename: Alan
authors.initials: A
authors.lastname: Kleinfeld
authors.affiliation: Fluoresprobe Sciences, San Diego, CA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Huber
authors.affiliation: Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY.
authors.forename: Barry
authors.initials: B
authors.lastname: Weinberger
authors.affiliation: MidAtlantic Neonatology Associates, Goryeb Children's Hospital, Morristown, NJ.
authors.forename: Naureen
authors.initials: N
authors.lastname: Memon
authors.affiliation: Rutgers School of Public Health, Rutgers University, New Brunswick, NJ.
authors.forename: Weichung Joe
authors.initials: WJ
authors.lastname: Shih
authors.affiliation: Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers, The State University of NJ, New Brunswick, NJ.
authors.forename: Mary
authors.initials: M
authors.lastname: Carayannopoulos
authors.affiliation: Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI.
authors.forename: William
authors.initials: W
authors.lastname: Oh
mesh_terms: D001663:Bilirubin / Q000097:blood*; D004655:Emulsions / Q000008:administration & dosage / Q000494:pharmacology; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007262:Infusions, Intravenous; D008297:Male; D010743:Phospholipids / Q000008:administration & dosage / Q000494:pharmacology*; D010789:Phototherapy; D013024:Soybean Oil / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D004655:Emulsions; D005230:Fatty Acids, Nonesterified; D010743:Phospholipids; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil; D001663:Bilirubin
keywords: lipid; phototherapy; premature infant; unbound bilirubin