Are bilirubin and plasma lipid profiles of premature infants dependent on the lipid emulsion infused?

Moshe Rubin, Nora Naor, Lea Sirota, Asher Moser, Ronit Pakula, Daniella Harell, Jacqueline Sulkes, Shmuel Davidson, Dov Lichtenberg

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31 Scopus citations

Abstract

The effect of a lipid emulsion containing long-chain triglycerides (LCT) and supplemented with L-car-nitine on plasma lipids and bilirubin in premature neonates on total parenteral nutrition was compared to that of lipid emulsions containing either LCT or a mixture of LCT and medium-chain triglycerides (MCT). In a double-blind randomized study 49 premature neonates received one of the three fat emulsions, given intravenously, over 16-20 h daily for 6 days. Plasma carnitine levels increased significantly in the supplemented group only; the addition of carnitine did not seem to affect any of the parameters studied. Mean plasma triglycerides rose by 193 and 199% in the carnitine-supplemented and the LCT groups, respectively, and by 314% in the MCT/LCT group. On the sixth day of the study free fatty acids were significantly higher in the MCT/LCT group than in the other two groups. Plasma phospholipids and free cholesterol increased (p < 0.05) progressively in all groups and were correlated (r = 0.74, p < 0.001). At the end of the 6-day study all groups showed a similar decline in free and total bilirubin levels despite the significant increase in plasma lipids and free fatty acids resulting from the stepwise increase in lipid load. No correlation was found between free fatty acids and free bilirubin. Since hyperbilirubinemia and hypertriglyceridemia appear to be clinically independent factors, the infusion of lipids should not be withheld from jaundiced infants on total parenteral nutrition.

Original languageEnglish
Pages (from-to)25-30
Number of pages6
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume21
Issue number1
DOIs
StatePublished - 1 Jan 1995
Externally publishedYes

Keywords

  • Bilirubin
  • Carnitine
  • Jaundice
  • Lipid emulsion

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