Alternative lipid emulsions versus pure soy oil based lipid emulsions for parenterally fed preterm infants

Record type Uncertainties identified in research recommendations
Source Cochrane Neonatal Group
Why is there uncertainty? Reliable up-to-date systematic reviews have revealed important continuing uncertainties about treatment effects

Original Uncertainty

Implications for Research Large randomised studies focusing on clinically important outcomes such as death, growth, BPD, neurodevelopment, ROP, and PNALD as their primary outcomes are required to evaluate the effectiveness of newer LE compared with the conventional pure soy oil based LE in preterm infants. Studies aiming to explore the effect of fish oil based LE on ROP should be adequately powered to detect a difference in the clinically important outcome of ROP ? stage 3 in light of reports of decreases in early stages of ROP with fish oil based LE. Future studies should also focus on specific ?at risk? population subgroups (e.g. extreme prematurity, preterm infants on long term PN, etc) and aim to explore the effect of different proportions of lipid constituents including fish oil and olive oil on morbidity and mortality in preterm infants.


References to reliable up-to-date systematic reviews:

Kapoor V, Glover R, Malviya MN. Alternative lipid emulsions versus pure soy oil based lipid emulsions for parenterally fed preterm infants. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No.: CD009172. DOI: 10.1002/14651858.CD009172.pub2

What is needed? Further research
Systematic reviews that need updating or extending None identified
Systematic reviews in preparation None identified
Ongoing controlled trials Preventing cholestasis using SMOFLipid NCT01585935 Effects of parenteral nutrition with different lipid emulsions in preterm infants NCT01683162

Classification

Which health conditions? Neonatal diseases
What is person's age? Child / Adolescent
Which types of treatments? Diet

Which Outcomes

Change in symptoms, or change in management of symptoms (Incidence and prevalance of bronchopulmonary, dysplasia, mortality, growth rate, time (days) to regain birth weight); adverse effects or complications (Retinopathy of prematurity (ROP) stage 1-2 sepsis, PN associated liver disease (PNALD)/cholestasis, ventilation duration, necrotising enterocolitis (NEC), jaundice requiring treatment, intraventricular haemorrhage, periventricular leukomalacia (PVL), patent ductus arteriosus (PDA), hypertriglyceridaemia, and hyperglycaemia neurodevelopmental outcomes. essential fatty acid deficiency); patient satisfaction; health related quality of life; service related issues; and health related cost


Record ID: Publication date:10 Mar 2016
Last reviewed date:10 Mar 2017 Publication Type:Known Uncertainty
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