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NOTE LIST

Summary

  • Use of fish oil has shown to reverse cholestasis, but
  • Mixed emulsion seems to be more beneficial than fish oil alone
  • Combination of lipid emulsion that includes all 4 types of lipids – shown to have better outcomes

Recommendations 

  • For those with Intestinal failure requiring long PN >14-27days
  • Presence of fish oil in mixed lipid emulsion has shown to:
    • ↓oxidative stress and ↑ antioxidant actvity
    • ↑ fatty acids – EPA & DHA
    • Lower plasma phytosterol content
    • Reducing ROP laser therapy – potential prevention ROP
  • Critically ill – potentially altering the inflammatory response

Conclusion:

  • There has been an advancement in lipid emulsions over last 10 years
  • Optimal composition of lipid emulsions is needed to enhance benefits but also to minimise risk of complications
  • Well designed long term Randomised Control Trials are needed for stronger evidence
  • But the new mixed Lipid Emulsion has great potential impact on clinical outcomes – such as sepsis, cholestasis and neurological development
  • The available research – though with its limitations – does show benefit in reversal of PNAC & for premature infants

 

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