Commentary on “Lipid Emulsions for Parenterally Fed Preterm Infants”

Abstract

Lipid emulsions provide essential fatty acids and lipid soluble vitamins, as well as a substantial fraction of the non-protein energy content of parenteral nutrition for supporting preterm or sick newborn infants. Traditional soybean oil-based emulsions, however, contain few medium-chain triglycerides and insufficient levels of omega-3 long-chain polyunsaturated fatty acids such as eico­sapentaenoic acid and docosahexaenoic acid to meet recommended needs. Consequently, soybean oil-based emulsions are thought to have low antioxidant capacity, and use has been associated with adverse effects attributed to oxidative stress, lipid peroxidation, and inflammation. A common clinical concern is that prolonged administration of soybean oil-based emulsions contributes to the pathogenesis of cholestatic “parenteral nutrition-associated liver disease” (PNALD) that can progress to hepatic steatosis, fibrosis, and liver failure [1].