Abstract：
BACKGROUND: Pediatric patients with intestinal failure require long-term parenteral nutrition owing to impaired enteral nutrition absorption. A potential complication is essential fatty acid deficiency (EFAD), resulting from decreased linoleic and α-linolenic acid concentrations and defined by an increased triene:tetraene ratio (TTR; Mead acid:arachidonic acid). Historically, soybean oil lipid emulsion (SOLE) was the only commercially available parenteral lipid in the United States. Recently, a composite lipid emulsion (CLE) and fish oil lipid emulsion (FOLE) received US Food and Drug Administration approval. This study investigated whether lipid emulsion regimen impacts EFAD incidence in pediatric patients with intestinal failure.
METHODS: This study was a 10-year retrospective cohort study of pediatric patients with intestinal failure who received parenteral SOLE, CLE, or FOLE. The primary outcome was EFAD incidence, defined as a TTR ≥ 0.2. Secondary outcomes included TTR ≥ 0.05, cholestasis incidence, lipid dose effect on EFAD incidence, and fatty acid parameter differences.
RESULTS: A total of 144 fatty acid profiles from 47 patients were reviewed. EFAD did not occur in any lipid emulsion group. There were no differences in the incidence of TTR ≥ 0.05 or cholestasis. The effect of dose could not be evaluated because of no EFAD incidence. Lastly, although each group had varied fatty acid parameters, none saw decreased essential fatty acid levels.
CONCLUSIONS: This study found that, with close monitoring, the lipid emulsion regimen did not impact EFAD incidence. This suggests that FOLE and CLE do not increase EFAD risk compared with SOLE in pediatric patients with intestinal failure.
METHODS: This study was a 10-year retrospective cohort study of pediatric patients with intestinal failure who received parenteral SOLE, CLE, or FOLE. The primary outcome was EFAD incidence, defined as a TTR ≥ 0.2. Secondary outcomes included TTR ≥ 0.05, cholestasis incidence, lipid dose effect on EFAD incidence, and fatty acid parameter differences.
RESULTS: A total of 144 fatty acid profiles from 47 patients were reviewed. EFAD did not occur in any lipid emulsion group. There were no differences in the incidence of TTR ≥ 0.05 or cholestasis. The effect of dose could not be evaluated because of no EFAD incidence. Lastly, although each group had varied fatty acid parameters, none saw decreased essential fatty acid levels.
CONCLUSIONS: This study found that, with close monitoring, the lipid emulsion regimen did not impact EFAD incidence. This suggests that FOLE and CLE do not increase EFAD risk compared with SOLE in pediatric patients with intestinal failure.
摘要：
背景：患有肠衰竭的小儿患者由于肠内营养吸收受损而需要长期肠外营养。潜在的并发症是必需脂肪酸缺乏（EFAD），由于亚油酸和α-亚麻酸浓度降低，并由三烯：四烯比率增加（TTR；米德酸：花生四烯酸）定义。历史上,大豆油脂质乳液（SOLE）是美国唯一可商购的肠胃外脂质。最近,复合脂质乳剂（CLE）和鱼油脂质乳剂（FOLE）获得了美国食品和药物管理局的批准。这项研究调查了脂质乳剂方案是否影响肠衰竭患儿的EFAD发生率。
方法：本研究是一项为期10年的回顾性队列研究，对接受肠外SOLE治疗的肠衰竭患儿进行研究，CLE,或FOLE。主要结果是EFAD发病率，定义为TTR≥0.2。次要结局包括TTR≥0.05，胆汁淤积发生率，脂质剂量效应对EFAD发病率的影响，和脂肪酸参数分歧。
结果：共分析了47例患者的144份脂肪酸谱。任何脂肪乳组均未发生EFAD。TTR≥0.05或胆汁淤积的发生率无差异。由于没有EFAD的发生率，因此无法评估剂量的影响。最后,尽管每组都有不同的脂肪酸参数，没有人看到必需脂肪酸水平降低。
结论：这项研究发现，密切监测,脂质乳剂方案不影响EFAD的发生率.这表明FOLE和CLE在肠衰竭的儿科患者中与SOLE相比不会增加EFAD的风险。
方法：本研究是一项为期10年的回顾性队列研究，对接受肠外SOLE治疗的肠衰竭患儿进行研究，CLE,或FOLE。主要结果是EFAD发病率，定义为TTR≥0.2。次要结局包括TTR≥0.05，胆汁淤积发生率，脂质剂量效应对EFAD发病率的影响，和脂肪酸参数分歧。
结果：共分析了47例患者的144份脂肪酸谱。任何脂肪乳组均未发生EFAD。TTR≥0.05或胆汁淤积的发生率无差异。由于没有EFAD的发生率，因此无法评估剂量的影响。最后,尽管每组都有不同的脂肪酸参数，没有人看到必需脂肪酸水平降低。
结论：这项研究发现，密切监测,脂质乳剂方案不影响EFAD的发生率.这表明FOLE和CLE在肠衰竭的儿科患者中与SOLE相比不会增加EFAD的风险。
