Impact of parenteral lipid emulsion components on cholestatic liver disease in neonates

Authors: GUTHRIE, GREGORY - Children'S Nutrition Research Center (CNRC); Burrin, Douglas - Doug

Submitted to: Nutrients
Publication Type: Review Article
Publication Acceptance Date: 2/2/2021
Publication Date: 2/4/2021
Citation: Guthrie, G., Burrin, D.G. 2021. Impact of parenteral lipid emulsion components on cholestatic liver disease in neonates. Nutrients. 13(2):508. https://doi.org/10.3390/nu13020508.
DOI: https://doi.org/10.3390/nu13020508

Interpretive Summary:

Technical Abstract: Total parenteral nutrition (TPN) is a life-saving intervention for infants that are unable to feed by mouth. Infants that remain on TPN for extended periods of time are at risk for the development of liver injury in the form of parenteral nutrition associated cholestasis (PNAC). Current research suggests the lipid component of TPN is a factor in the development of PNAC. Most notably, the fatty acid composition, vitamin E concentration, and presence of phytosterols are believed key mediators of lipid emulsion driven PNAC development. New emulsions comprised of fish oil and medium chain triglycerides show promise for reducing the incidence of PNAC in infants. In this review we will cover the current clinical studies on the benefit of fish oil and medium chain triglyceride containing lipid emulsions on the development of PNAC, the current constituents of lipid emulsions that may modulate the prevalence of PNAC, and potential new supplements to TPN to further reduce the incidence of PNAC.