The Effect of Parenteral Lipid Emulsions on Pulmonary Hemodynamics and Eicosanoid Metabolites in Preterm Infants: A Pilot Study

• Published in: Nutrition in clinical practice 2013-12, Vol.28 (6), p.753-757
• Main Authors: Vasudevan, Chakrapani, Johnson, Kathryn, Miall, Lawrence S., Thompson, Douglas, Puntis, John
• Format: Article
• Language: English
• Subjects: Blood Pressure - drug effects; Dietary Fats - pharmacology; Eicosanoids - urine; Fat Emulsions, Intravenous - pharmacology; Glycine max - chemistry; Hemodynamics; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Premature; Linoleic Acid - pharmacology; Olea - chemistry; Olive Oil; Parenteral Nutrition; Pilot Projects; Plant Oils - chemistry; Plant Oils - pharmacology; Prostaglandins F - blood; Pulmonary Artery - drug effects; Pulmonary Artery - physiology; Soybean Oil - chemistry; Soybean Oil - pharmacology; Thromboxane B2 - urine
• ISSN: 0884-5336; 1941-2452
• DOI: 10.1177/0884533613507285

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.