Higher Doses of Fish Oil-Based Lipid Emulsions Used to Treat Inadequate Weight Gain and Rising Triene:Tetraene Ratio in a Severely Malnourished Infant With Intestinal Failure-Associated Liver Disease.

Document Type

Article

Publication Date

5-1-2017

Institution/Department

Pediatrics

Journal Title

JPEN. Journal of parenteral and enteral nutrition

MeSH Headings

Cholestasis, Dose-Response Relationship, Drug, Fat Emulsions, Intravenous, Female, Fish Oils, Humans, Infant, Intestinal Diseases, Liver Diseases, Malnutrition, Parenteral Nutrition, Weight Gain

Abstract

Fish oil-based lipid emulsions (FOLEs) have been used to treat cholestasis in children with intestinal failure-associated liver disease (IFALD). When FOLEs are dosed at 1 g/kg/d, essential fatty acid (EFA) deficiency typically does not occur. We describe the clinical course of a severely malnourished parenteral nutrition-dependent infant with IFALD. Baseline EFA panels were normal upon starting FOLE at 1 g/kg/d. Despite biochemical improvement in IFALD, weight velocity was below target and biochemical EFA status worsened, even after correction for other factors affecting weight. The FOLE dose was increased to 1.5 g/kg/d, resulting in improvement of weight velocity and EFA status. This suggests that in severely malnourished infants being treated for IFALD, higher doses of FOLE may be required for adequate growth and to prevent EFA deficiency.

ISSN

1941-2444

First Page

667

Last Page

671

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