Presented at the Neonatal Society 2016 Summer Meeting.
Barrielle L, Rubio A, Marcus L, Cneude F, Debillon T
Neonatal Intensive Care Unit, Universitary Hospital of Grenoble, Grenoble, France
Background: Lipids are essential in preterm nutrition as a high-density energy source and they contribute to reducing early energy deficit and catabolism, and promote protein accretion. Despite their qualities, there is still a reluctance to use early intravenous lipids.
Methods: We analyzed a retrospective cohort to determine whether early introduction of lipids (1st day versus 3rd day of life) was associated to a reduction in initial weight loss. Nutritional and growth data were collected during hospital stay. The tolerance was evaluated on both clinical (sepsis, icterus) and biological sides (triglyceridemia, cholesterolemia, glycaemia).
Results: Fifty-seven preterm infants were included in the early lipid group (lipid introduction before 24h of life), and 71 in the late lipid group (on the third day of life). Maximal weight loss was lower in the early lipid group (7.4% vs. 9.4%, p=0.005) and the delay before regaining the birth weight was also shorter in this group (8 days vs. 9.6 days, p=0.004). There was no difference concerning the duration of parenteral nutrition between the 2 groups (early lipids 20.1 days versus late lipids 20.7, p=0.83). Triacylglycerol concentrations did not differ between the 2 groups at day 8 and there was no difference either concerning hyperglycemia or need for insulin therapy. The incidence of sepsis was not greater in the early lipid group (29.8% vs. 30.9%, p=0.88) and the number of required phototherapy days for icterus was lower in the early lipid group (2.2 days vs. 3.2 days, p=0.02). Clinical outcome was not different between the 2 groups.
Conclusion: Our study suggests that early lipid infusion reduces the initial weight loss and is well tolerated. Further prospective studies are necessary to argument the benefit of this nutritional strategy.
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